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顺铂和长春瑞滨作为子宫颈癌患者一线化疗的II期研究。

Phase II study of cisplatin and vinorelbine as first-line chemotherapy in patients with carcinoma of the uterine cervix.

作者信息

Pignata S, Silvestro G, Ferrari E, Selvaggi L, Perrone F, Maffeo A, Frezza P, Di Vagno G, Casella G, Ricchi P, Cormio G, Gallo C, Iodice F, Romeo F, Fiorentino R, Fortuna G, Tramontana S

机构信息

Divisione di Oncologia Medica B, Istituto Nazionale Tumori, Napoli, Italy.

出版信息

J Clin Oncol. 1999 Mar;17(3):756-60. doi: 10.1200/JCO.1999.17.3.756.

Abstract

PURPOSE

To evaluate the activity and toxicity of the combination of cisplatin (80 mg/m2 day 1) and vinorelbine (25 mg/m2 days 1 and 8) in patients with carcinoma of the uterine cervix that has not been previously treated with chemotherapy.

PATIENTS AND METHODS

Fifty patients with cervical cancer were enrolled onto this study (27 stage IB-III, 23 stage IVB-recurrent). A two-stage optimal Simon design was applied. Thirteen responders of 29 treated patients were required to proceed beyond the first stage, and 28 responders were needed overall.

RESULTS

Hematologic toxicity was mild, with neutropenia being the most frequent side effect. Nonhematologic toxicity was frequent but never severe; one patient had grade 3 peripheral neurotoxicity. Objective responses were recorded for 32 patients (64%): 11 patients (22%) achieved a complete response (CR) and 21 patients (42%) achieved a partial response (PR). The response rate was 81.5% in patients with IB-III stage (25.9% CR rate) and 43.5% in patients with IVB-recurrent disease (17.4% CR rate). Responses were seen both in stage IVB patients (one CR and two PRs, for an overall rate of 37.5%) and in patients with recurrent disease (three CRs + four PRs, for an overall rate of 46.7%).

CONCLUSION

The combination of cisplatin and vinorelbine is an active regimen in the treatment of patients with early-stage and advanced carcinoma of the uterine cervix. The hematologic and nonhematologic toxicity of this combination is mild.

摘要

目的

评估顺铂(80mg/m²,第1天)和长春瑞滨(25mg/m²,第1天和第8天)联合用药对先前未接受过化疗的子宫颈癌患者的活性和毒性。

患者与方法

50例宫颈癌患者纳入本研究(27例为IB - III期,23例为IVB期 - 复发期)。采用两阶段最优西蒙设计。29例接受治疗的患者中需要13例有反应者进入第二阶段,总体需要28例有反应者。

结果

血液学毒性较轻,中性粒细胞减少是最常见的副作用。非血液学毒性常见但从不严重;1例患者有3级周围神经毒性。32例患者(64%)记录到客观反应:11例患者(22%)达到完全缓解(CR),21例患者(42%)达到部分缓解(PR)。IB - III期患者的缓解率为81.5%(CR率为25.9%),IVB期 - 复发病例患者的缓解率为43.5%(CR率为17.4%)。IVB期患者(1例CR和2例PR,总缓解率为37.5%)和复发病例患者(3例CR + 4例PR,总缓解率为46.7%)均有反应。

结论

顺铂和长春瑞滨联合用药是治疗早期和晚期子宫颈癌患者的有效方案。该联合用药的血液学和非血液学毒性较轻。

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