Paskeviciute Ligita, Roed Henrik, Engelholm Svend
Department of Oncology, Finsen Center, Copenhagen University Hospital, DK-2100 Copenhagen, Denmark.
Gynecol Oncol. 2002 Sep;86(3):297-301. doi: 10.1006/gyno.2002.6778.
Second-line chemotherapy in platinum/paclitaxel-resistant ovarian cancer induces an objective response in <15% and third-line chemotherapy results in responses less than 10%. Chemotherapy always results in side effects with the risk of a low quality of life. Endocrine therapy is used world-wide among chemo-resistant ovarian cancer. Tamoxifen is a standard palliative treatment in many centers. LH-RH (luteinizing hormone-releasing hormone) agonists have also demonstrated activity among patients with ovarian cancer in several studies with response rates of 9-12% and disease stabilization in 15-26% of these women.
In this retrospective study 32 patients with ovarian cancer who had relapsed after platinum/paclitaxel-based first-line chemotherapy and had exhausted all standard treatments received LH-RH analogue Leuprorelin depot 3.75 mg sc once a month until tumor progression.
One patient (3%) had a complete response, with remission time over 3 years. Two patients (6%) reached partial response with remission time of 3 and 4 months. Four patients (12%) remained stable for a mean time of 7 months (range 4-12 months). The remaining 25 patients (78%) had progressive disease. The treatment was well tolerated, and no major toxicity has been reported.
This study showed that LH-RH agonist Leuprorelin has only a limited effect in patients pretreated with platinum-based chemotherapy.
铂类/紫杉醇耐药的卵巢癌患者接受二线化疗时客观缓解率低于15%，三线化疗的缓解率则低于10%。化疗总会带来副作用，存在生活质量降低的风险。内分泌治疗在全球范围内用于化疗耐药的卵巢癌患者。他莫昔芬在许多中心是标准的姑息治疗药物。多项研究表明，促黄体激素释放激素（LH-RH）激动剂在卵巢癌患者中也有活性，缓解率为9%-12%，15%-26%的患者病情稳定。
在这项回顾性研究中，32例卵巢癌患者在接受以铂类/紫杉醇为基础的一线化疗后复发，且已用尽所有标准治疗方法，每月皮下注射一次3.75 mg的LH-RH类似物亮丙瑞林长效注射剂，直至肿瘤进展。
1例患者（3%）完全缓解，缓解时间超过3年。2例患者（6%）达到部分缓解，缓解时间分别为3个月和4个月。4例患者（12%）病情稳定，平均稳定时间为7个月（范围4-12个月）。其余25例患者（78%）病情进展。该治疗耐受性良好，未报告重大毒性反应。
本研究表明，LH-RH激动剂亮丙瑞林对接受过铂类化疗的患者效果有限。
