Ifosfamide in the Treatment of Bronchogenic Carcinoma and Metastatic Lung Tumor

Abstract

A total of 44 patients (36 bronchogenic carcinoma and 8 metastatic lung tumor) were treated with ifosfamide in dose of 150-200mg/kg, fractionated to 3-5 consecutive days, every 3 weeks. All patients had disseminated conditions, and 21 had previous chemotherapy. Bladder toxicity was minimized by oral and/or parenteral high fluid intake, and bladder irrigation was not utilized. In bronchogenic carcinoma patients (8 adeno, 1 large cell, 1 alveolar, 7 squamous and 19 small cell), 8 of 32 evaluable patients responded positively with the effect lasting 1.5 to 8 months (median, 4 months). Seven responders (1 complete and 2 parital) had small cell carcinoma and one partial responder had adenocarcinoma. All of the 3 cervical carcinoma patients with pulmonary metastases responded to the therapy (1 complete and 2 partial), but no positive response was observed in 5 patients with metastatic lung tumor (originated from ovarian carcinoma, endometorial carcinoma, malignant neurinoma, hemangiosarcoma and rhabdomyosarcoma). Myelosuppressive toxicity was mild: leukopenia (less than 2, 000/cmm) occurred in 12% and thrombocytopenia (less than 100, 000/cmm) in 10% of patients. Bladder toxicity occurred in 51% of patients (macrohematuria constituted 17%). Upper gastrointestinal symptoms, such as nausea and vomitingoccurred in one-half of patients. The overall response rate was 28%(11/40 evaluable patients). In conclusion, ifosfamide appears effective in the management of disseminated cervical carcinoma, as well as small cell lung carcinoma, and should be considered in combination therapy with other agents.