Ifosfamide in patients with recurrent non small cell lung cancer

Abstract

Summary1Recurrent intrathoracic disease remains an important problem in patients with non-small cell lung cancer (NSCLC). Data in the literature support the general assumption that patients previously treated with irradiation and/or chemotherapy have a very poor survival rate. Between May 1983 and May 1984, we treated 21 patients (20 males, 1 female; median age: 58 years; median performance status: 70) with ifosfamide. All patients had locoregional tumor progression with 2 patients having additional bone metastases. Patients with liver metastases were excluded from our study. Tumor histology included squamous cell carcinoma (n = 18), adenocarcinoma (n = 2) and alveolar-cell carcinoma (n = 1). Pretreatment consisted of radiotherapy in all patients and additional chemotherapy in 5 patients. Ifosfamide was administered by continuous infusion over 4 days (median dose: 1.75 g/m2 B.S.A./24 h). Mesna was given in a dose of 200 mg every 4 h i.v. Generally treatment was well tolerated, with gastrointestinal toxicity usually grade 1 (WHO criteria). Regarding myelosuppressive toxicity, there was no grade 3 or 4 toxicity. In only 1 patient did we observe progressive disease, while in 17 patients we noticed stable disease. Median time to progression was 7.0 months. From these 17 patients 11 showed a significant clinical improvement. According to standard criteria there was PR in 2 and CR in 1 patient. From this study we conclude that ifosfamide in pretreated and recurrent NSCLC administered by continuous infusion is tolerable and apparently prolongs the median duration of response.