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1978年国立癌症研究所(NCI)就开始了异环磷酰(IF)的临床试用。早期单药应用的结果显示,该药对于复发的非何杰金淋巴瘤(NHL)(有效率29％)、各种肉瘤和其他实体瘤(有效率27％)均有效。随后又将IF与足叶乙甙(Vp—16)和大剂量阿糖胞苷(Ara—c)联合应用于淋巴瘤,或单与Vp—16联合应用于肉瘤和其它实体瘤,则疗效更加显著——NHL病人应用IF、Vp—16和Ara—c三药联合方案的有效率为69％,而仅用IF和Vp—16二药联合方案的有效率为41％。在肉瘤病人中,全部入组的45例病人(3例单药,42例IF和Vp—16)在单用化疗或在化疗前后辅以手术或放疗后均获无病生存,其中20例病人生存2—8年。18例目前仍无病生存。在这些病人中,有11例一直处于完全缓解。由于上述这些良好的结果,我们正进一步考虑将IF纳入NHL和肉瘤的一线治疗方案之中。
In 1978, the National Cancer Institute (NCI) began a clinical trial of IF. Early single-agent results showed that the drug was effective for relapsed non-Hodgkin’s lymphoma (NHL) (29% effective rate), various sarcomas, and other solid tumors (27% effective rate). Subsequent use of IF in combination with epinephrine (Vp-16) and high-dose cytarabine (Ara-c) in lymphomas or in combination with Vp-16 alone in sarcomas and other solid tumors is associated with greater efficacy. Significantly, the effective rate of the combination of IF, Vp-16, and Ara-c in NHL patients was 69%, while the combined rate of IF and Vp-16 dual drugs alone was 41%. Among the patients with sarcoma, all of the 45 patients enrolled in the study (3 single agents, 42 IF and Vp-16) were disease-free and survived after chemotherapy alone or with chemotherapy or radiotherapy. Survive 2-8 years. Eighteen cases are still disease free. Of these patients, 11 have been in complete remission. Due to these good results above, we are further considering the inclusion of IF in the first-line treatment of NHL and sarcoma.