Chi D S, Waltzman R J, Barakat R R, Spriggs D R
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Eur J Gynaecol Oncol. 1999;20(4):277-80.
To evaluate the efficacy of intravenous (i.v.) paclitaxel and platinum chemotherapy in patients with high-risk Stage I epithelial ovarian carcinoma.
We performed a retrospective chart review of all patients with Stage I ovarian cancer treated at our institution between March 1993 and June 1995.
Twenty patients received adjuvant paclitaxel-containing chemotherapy for Stage I ovarian carcinoma after comprehensive surgical staging. Five patients (25%) had Stage IA disease and 15 patients (75%) had Stage IC disease. Tumor grades were: 1, five patients (25%); 2, nine patients (45%); and 3, six patients (30%). Histologic cell types were: clear-cell, ten (50%); endometrioid, five (25%); mucinous, three (15%); and serous, two (10%). Nineteen patients (95%) were treated with i.v. paclitaxel and platinum chemotherapy. One patient (5%) received i.v. paclitaxel alone. Eighteen patients (90%) had five cycles of chemotherapy, while two patients (10%) had three. The 96 total cycles were associated with nine episodes (9%) of significant toxicity: fever, four (4%); severe nausea and vomiting, two (2%); Clostridium difficile enteritis, one (1%); congestive heart failure, one (1%); and anemia, requiring blood transfusion, one (1%). With a median follow-up of 36 months (range 24-50 mos), all 20 patients are alive, and 19 (95%) are disease-free. The one patient (5%) treated with i.v.++paclitaxel alone developed an abdominal recurrence 22 months after diagnosis.
Primary i.v.++paclitaxel and platinum chemotherapy in patients with high-risk Stage I epithelial ovarian carcinoma is reasonably well tolerated and may improve survival. Larger studies with long-term follow-up are needed.
评估静脉注射紫杉醇联合铂类化疗对高危Ⅰ期上皮性卵巢癌患者的疗效。
我们对1993年3月至1995年6月在本机构接受治疗的所有Ⅰ期卵巢癌患者进行了回顾性病历审查。
20例患者在全面手术分期后接受了含紫杉醇的Ⅰ期卵巢癌辅助化疗。5例（25%）为ⅠA期疾病，15例（75%）为ⅠC期疾病。肿瘤分级为：1级，5例（25%）；2级，9例（45%）；3级，6例（30%）。组织学细胞类型为：透明细胞，10例（50%）；子宫内膜样，5例（25%）；黏液性，3例（15%）；浆液性，2例（10%）。19例（95%）患者接受了静脉注射紫杉醇联合铂类化疗。1例（5%）患者仅接受了静脉注射紫杉醇。18例（90%）患者进行了5个周期的化疗，2例（10%）患者进行了3个周期。96个周期总共出现9次（9%）严重毒性反应：发热，4次（4%）；严重恶心和呕吐，2次（2%）；艰难梭菌肠炎，1次（1%）；充血性心力衰竭，1次（1%）；贫血，需要输血，1次（1%）。中位随访36个月（范围24 - 50个月），所有20例患者均存活，19例（95%）无疾病。仅接受静脉注射紫杉醇治疗的1例（5%）患者在诊断后22个月出现腹部复发。
高危Ⅰ期上皮性卵巢癌患者采用静脉注射紫杉醇联合铂类进行初始化疗耐受性较好，可能改善生存率。需要进行更大规模的长期随访研究。
