135

and vomiting were relieved by administra-

tion of clebopride. Hair loss was a co~on side effect. Bone marrow toxicity was mild. IF/Mesna as i.v. 24 h infusion plas Cis-P is a useful plan for advanced NSCLC treat- ment, median survival time 6 months (range 2-12).

Treatment of NSCLC With Mitomycin C, Vinde- sine and Ifosfamide - Results of A Phase- II Trial. Gatzemeier, ~., Hossfeld I, D.K., Radenbach, D., Zschaber , R., Department of Pneumology Grosshansdorf Hospital. i. Department of Hematology and Oncology University of Hamburg, 2070 Grosshansdorf, West Germany.

Mitomycin C, ifosfamide and vindesine are some of the most effective drugs in the treatment of NSCLC. Experimental data showed that there were additive synergism between the substances, too. In a phase-II trial we looked for the effectiveness and side effects of these drug combination in patients with NSCLC.

Since 4/84 27 patients with inoperable NSCLC were entered into a phase-II trial using these three drugs, 24 male and 3 fe- male. 7 of them had received prior chemo- therapy (DDP/VP-16). The performance sta- tus of all patients was more than 70%. 7 patients had limited disease, 20 patients extensive disease. The histology was re- presented as follows: 20 squamous cell, 3 large cell, 4 adenocarc~nomas.

Dose-schedule:210 mg/m- i.v.d. I mi- 2 tomycin C; 3 mg/m i.v. d I VDS; 1,5 mg/m i.v.d. I-V Ifosfamide every 4 weeks.

The objective response rate was 47,8%, 2 patients (8,6%) had a CR, 9 patients (38,1%) PR. The GI side effects were mode- rate. Only 55,1% of all patients had nau- sea and vomiting with more than grade II WHO-scale. The hematological toxicity wasn't a problem either. The pulmonary toxicity, however, was more serious than expected. 3 of 29 patients (10,3%) got clinical symptoms with dyspnoe and respi- ratory insufficience. Looking at lung func- tional criteria (p02, DLCO) we found much more of pulmonary tSxicity (34,4%)

In summary, the combination mitomycin C, VDS and ifosfamide appears to be very effective in the treatment of NSCLC without the GI-toxicity such as cisplatinum. But the pulmonary toxicity of mitomycin C and its prevention has to be more noticed.

Chemotherapy of Non Small Cell Lung Cancer (NSCLC) With Ifosfamide and Etoposide. Drings, P., B~Izebruck, H., Kleckow, M., Manke, H.G. Chest Hospital Rorhbach, Hei- delberg, FRG.

91 patients with advanced N~CLC were treated with ifosfamide 20~0/m on days 1-5 and etoposide 120 mg/m on days 1-3.

The therapeutic regimen was repeated after 4 weeks. Supportive treatment wit~'mesna (20% on the ifosfamide dose at 0 and. 4 a~d 8 ~ours) was

performed. We achieved a response rate of 27,5%

(25/91 ) . Re,~,,e, ,ccordl.9 to prog,o,tic r,ct0r, CR PR NC Fa i lu re Total

HIsLoIogic type Sque~nus c e l l Ca. ] 8 ]2 l ] J~ Adeno~srcinoma 8 , ]6 10 ~4 Larqe c e l l Ca 8 , 8 7 Z)

LD n 06 - 10 ED 1 20 ) ]0 Bl

Pr ior chemotherapy gJiven 7 16 I0 )J not given ] 17 20 20 }8

The median survival time for all patients was 36 weeks for responders (CR + PR) 61 weeks (p<0,05), for NC patients 41 weeks, and for non- responders 16 weeks. Performance state and bone metastases had significant influence on the survival of patients. The toxicity was acceptab- le and lower than with cisplatin combinations.

The media~ leukocyte nadir was calculated with 2900~mm , the thrombocyte nadir with 236000/mm . Life threatening infections and bleedings didn't occur. A mild neurotoxicity, fever or stomatitis were observed in some pa- tients.

Ifosfamide Bohm Therapy For Advanced Non Small Cell Lung Cancer (NSCLC). Thatcher, N., Anderson, H., Stout, R., Carroll, K.B. Christie Hospital & Wythenshawe Hospital, Manchester, U.K.

Ifosfamide was given by 30 min. bolus admi- nistration rather than by the conventional, more inconvenient 24 hour infusion in a study of 50 patients with inoperable progressive NSCLC. There were 23 'limited' and 27 'extensive' stage patients. Histology was 50% squamous un- differentiated, not2small cell.

Ifosfamide 5 g7~ with mesna over 30 mins was followed by 1-3 subsequent doses of mesna oral- ly or i.v. in cases of marked nausea or vomiting. The courses were repeated at 3 week intervals for a total of 6. 176 courses were given in all, 26% of patients received all 6 planned courses.

The response rate was 28% (13 PR, 1 CR), 79% responses occurring by the 3rd course. 6% of patients had a Karnofsky score > 70 before treatment, and this increased to 50% 3 weeks after the last course of chemotherapy. Leucope- nia + anaemia were seen in 8% of all courses with 1 probably treatment related death, 6% of patients had reversible mental disturbance. Oral mesna was given on 40% of all courses and discharge within 8 hrs was considered possible on 55% of all courses.

The median survival for all patients was 5 months, for responders 9 months and for patients with symptomatic improvement, but with stable disease, 7 months. There is no significant difference in survival according to histological type.

Ifosfamide by bolus is well tolerated and pro- vides useful palliation for advanced NSCLC. A day case regimen is possible.