异环磷酰胺、长春酰胺和顺铂联合治疗晚期非小细胞肺癌

The combined chemotherapy of ifosfamide plus vindesine and cisplatin in advanced non-small cell lung cancer

目的 :评价异环磷酰胺 (IFO)、长春酰胺 (VDS)和顺铂 (DDP)联合治疗晚期非小细胞肺癌 (NSCLC)的疗效和毒性反应。方法 :5 2例晚期NSCLC给予IFO、VDS和DDP联合化疗 ,第 1～ 5天静脉滴注IFO 1.5～ 2 g/m2 ,美安 (mesna) 4 0 0mg ,在IFO后 0、4、8h静脉推注 ;第 1、8天静脉推注VDS 4mg ;第 1天静脉滴注DDP 6 0mg/m2 。 4周为一个周期 ,两个周期后评价疗效和毒性反应 ,随访生存期。结果 :IFO、VDS和DDP联合化疗总有效率为 4 4 .2 % ,初治和复治病例有效率分别为 4 7.1%和38.9% ,两组间差别无显著性 (P >0 .0 5 )。中位生存期为 8个月。毒性反应主要是骨髓抑制 ,表现为白细胞和血小板的减少较为明显 ,白细胞和血小板下降常出现于给药后第 8～ 12天。结论 :IFO、VDS和DDP联合治疗晚期NSCLC有较好的临床疗效 ,对复发病例也有较好疗效 ,毒性反应耐受性较好 ,如辅以G -CSF防治重度骨髓抑制 。

Objective:To evaluate the efficacy and toxicity of the combined chemotherapy of ifosfamide plus vindesine and cisplatin in advanced non-small cell lung cancer.Methods:Fifty-two patients with advanced non-small cell lung cancer were treated by the combined chemotherapy of ifosfamide plus vindesine and cisplatin for two cycles:ifosfamide 1.5～2.0g/m 2 iv drip on day 1～5,mesna 400mg iv at 0,4,8 hours after using ifosfamide;vindesine 4mg iv on day 1,8;cisplation 60mg/m 2 iv drip on day 1.The response,toxicity and survival period were evaluated.Results:The total response rate was 44.2%.The response rate of patients in primary treatment was 47.1% and that of return cases was 38.9% ( P >0.05).The median duration of survival was eight months.The major toxicity was the inhibition of bone marrow,especially of leukocyte and platelet.Leukopenia and thrombocytopenia often appeared at day 8～12.Conlusion:The combined chemotherapy of ifosfamide plus vindesine and cisplatin is effective in advanced non-small cell lung cancer including the returm cases,and the toxicity is tolerable.If G-CSF is used as a complementary therapy,this regimen could be quite clinically valuable.