Gladieff L, Chatelut E, Gaspard M H, Skaf R, de Forni M, Mihura J, Canal P, Bugat R
Unité de pharmacologie clinique, Institut Claudius-Regaud, 20-24, rue du Pont-Saint-Pierre, 31052 Toulouse Cedex.
Bull Cancer. 1999 Jul-Aug;86(7-8):673-7.
Consolidation treatment of advanced ovarian carcinoma, especially the place of intraperitoneal chemotherapy, remains a controversial subject. From January 1988 to July 1995, 39 patients, median age 54 years, received intraperitoneal chemotherapy as consolidation treatment after second-look surgery. At the time of intraperitoneal chemotherapy, 30 patients had no residual disease. Intraperitoneal drug administration used a Tenckoff catheter or a lumbar needle. Treatment combined 5 fluorouracil 1 g/m2 and cisplatin 200 mg/m2, associated with a systemic sodium thiosulfate rescue as nephroprotector. A pharmacological analysis was done for 9 patients: the exposure of peritoneal cavity to cisplatin exceeded that of the plasma by 11 fold. Hematologic and nephrologic toxicity were acceptable. The median follow-up is 43 months. The disease free survival is 36,6 months, but 48,5 months if no residual disease at the time of intraperitoneal chemotherapy. Consolidation treatment by intense intraperitoneal chemotherapy is a feasible approach and might be beneficial in chemosensitive patients devoid of macroscopic remnants, but must be compared with others approaches.
晚期卵巢癌的巩固治疗，尤其是腹腔内化疗的地位，仍然是一个有争议的话题。1988年1月至1995年7月，39例患者（中位年龄54岁）在二次探查手术后接受腹腔内化疗作为巩固治疗。在进行腹腔内化疗时，30例患者没有残留病灶。腹腔内给药采用Tenckoff导管或腰椎穿刺针。治疗方案为5-氟尿嘧啶1 g/m²和顺铂200 mg/m²，并联合使用硫代硫酸钠进行全身解救作为肾脏保护剂。对9例患者进行了药代动力学分析：腹腔内顺铂的暴露量比血浆高11倍。血液学和肾脏毒性是可接受的。中位随访时间为43个月。无病生存期为3年零6个月，但如果在腹腔内化疗时没有残留病灶，则为4年零8个月。通过强化腹腔内化疗进行巩固治疗是一种可行的方法，可能对没有肉眼可见残留病灶的化疗敏感患者有益，但必须与其他方法进行比较。
