异环磷酰胺/ mesna。回顾其抗肿瘤的活性,药代动力学性质,在癌症的治疗效果。

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Dechant KL, Brogden RN,皮尔金顿T, Faulds D

异环磷酰胺/ mesna。回顾其抗肿瘤的活性,药代动力学性质,在癌症的治疗效果。

药。1991年9月,42 (3):428 - 67。

PubMed ID
1720382 (在PubMed
]
文摘

异环磷酰胺是oxazaphosphorine烷化剂的广谱抗肿瘤的活性。它是一种前体药物在肝脏代谢,细胞色素P450混合功能氧化酶酶isofosforamide芥末、活跃的烷基化化合物。Mesna, uroprotective硫醇代理,是常规管理与异环磷酰胺,几乎消除了ifosfamide-induced出血性膀胱炎,肾单位减少毒性。治疗的研究,大多是noncomparative在自然界中,展示了异环磷酰胺的疗效/ mesna孤独,或更常见的组合方案的一个组成部分,在各种癌症。患者的复发或难治性传播nonseminomatous睾丸癌,异环磷酰胺的救助方案/ mesna,顺铂和依托泊苷或长春花碱生产大约四分之一的患者的完全缓解。作为一个组件感应和打捞的化疗方案,异环磷酰胺/ mesna产生了有利的反应率在小细胞肺癌,儿科固体肿瘤,非霍奇金和霍奇金淋巴瘤,卵巢癌。与异环磷酰胺诱导治疗/ mesna-containing化疗方案一直鼓励在非小细胞肺癌,成人软组织肉瘤,在先进的宫颈癌新辅助治疗。抢救治疗,异环磷酰胺/ mesna-containing组合在晚期乳腺癌有缓和作用,先进的宫颈癌。异环磷酰胺/ mesna可以引起反应病人耐火材料许多其他抗肿瘤的药物,包括环磷酰胺。与管理伴随mesna防止ifosfamide-induced urotoxicity,异环磷酰胺的主要毒性dose-limiting myelosuppression; leucopenia is generally more severe than thrombocytopenia. Reversible CNS adverse effects ranging from mild somnolence and confusion to severe encephalopathy and coma can occur in approximately 10 to 20% of patients after intravenous infusion, and the incidence of neurotoxicity may be increased to 50% after oral administration because of differences in the preferential route of metabolism between the 2 routes of administration. Other adverse effects of ifosfamide include nephrotoxicity, alopecia, and nausea/vomiting. In general, intravenously administered mesna is associated with a low incidence of adverse effects; however, gastrointestinal disturbances are common following oral administration. Thus, ifosfamide/mesna is an important and worthwhile addition to the currently available range of chemotherapeutic agents. It has a broad spectrum of antineoplastic activity and causes less marked myelosuppression than many other cytotoxic agents. At present, the role of ifosfamide/mesna in refractory germ cell testicular cancer is clearly defined; however, its overall place in the treatment of other forms of cancer awaits delineation in future well-controlled comparative studies.

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