The alkylating agent ifosfamide, an analog of cyclophosphamide, has demonstrated significant antineoplastic effect is induced by hydroxylation of the 4-carbon in oxazaphosphorine ring and suppression of cellular DNAF replication. The combined
regimens
with ifosfamide have been studied for the management of patients with recurrent or persistent gynecologic malignacies from May 1991 through March 1993 at the Department of Obstetrics and Gynecology, Hanyang University Hospital and the following
results
were obtained.
1) The clinical responses. 1 complete, and 8 partial responses have been obtained in 9 patients (60%) among 15 patients with persistent or recurrent cervical cancer. The overall median survival was 5+months(range, 2~22+months) and 6 patients are
still
alive.
2) The clinical responses in the group of ovarian cancer revealed partial responses in 7 patients(70%) among 10 patients. The overall median survival was 16+months(range, 4~23+months) and 5 patients are still alive.
3) The various toxicities have been noticed in all patient including grade 1~3 gastrointestinal toxicity, and bone marrow depression. Furthermore, severe hemorrhagic cystitis was developed in one patient and severe CNS toxicity in four patients.
The results showed that the ifosfamide combination chemotherapy may be an effective second-line regimen in recurrent or persistent gynecologic malignancies. However, the duration of survival has been very short with these schedules and dosages,
and
the
real benefit of combination chemotherapy with the base of ifosfamide should be held until prolongation of survaval is proven objectively following the trials including dose escalation or various biochemical modulation.
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