Goff Barbara A, Thompson Tove, Greer Benjamin E, Jacobs Andrew, Storer Barry
Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, 98195-6460, USA.
Am J Obstet Gynecol. 2003 Jun;188(6):1556-62; discussion 1562-4. doi: 10.1067/mob.2003.398.
This study was undertaken to determine the degree of toxicity, response rate, and evaluate quality of life (QOL) in women receiving gemcitabine in combination with doxorubicin for platinum-resistant and refractory ovarian or peritoneal cancer.
This was a phase I/II prospective trial.
Nine patients were enrolled in the phase I portion. Initial doses of gemcitabine, 800 mg/m(2) intravenously on days 1, 8, and 15, and doxorubicin, 25 mg/m(2) intravenously on days 1, 8, and 15 in a 28-day cycle resulted in dose limiting toxicity secondary to thrombocytopenia and neutropenia. Forty patients were treated on the phase II portion with gemcitabine, 700 mg/m(2) intravenously on days 1 and 8, and doxorubicin 20 mg/m(2) intravenously on days 1 and 8 with granulocyte colony-stimulating factor administered on days 2 to 7 and 9 to 14 in a 21-day cycle. QOL was assessed with Fact-O.
The median number of previous chemotherapy regimens for the 49 women was 2 (range 1-5). There were 2 complete and 9 partial responses, for an overall response rate of 24%. Median duration of response was 5 months. Fourteen women (31%) had stable disease with median duration of response of 5 months. Median survival for the entire group was 12 months. Toxicity was primarily hematologic, and only 3 patients discontinued therapy because of toxicity. QOL surveys indicated that this was a well-tolerated regimen.
The combination of gemcitabine and doxorubicin can be safely administered. Overall, approximately 55% of women with platinum-resistant ovarian or peritoneal cancer benefit from this regimen with response or stabilization of disease.
本研究旨在确定接受吉西他滨联合多柔比星治疗铂耐药及难治性卵巢或腹膜癌的女性患者的毒性程度、缓解率,并评估其生活质量(QOL)。
这是一项I/II期前瞻性试验。
9名患者参与了I期试验部分。在28天的周期中,吉西他滨初始剂量为800mg/m²,于第1、8和15天静脉注射,多柔比星初始剂量为25mg/m²,于第1、8和15天静脉注射,结果出现了继发于血小板减少和中性粒细胞减少的剂量限制性毒性。40名患者参与了II期试验部分,在21天的周期中,吉西他滨剂量为700mg/m²,于第1和8天静脉注射,多柔比星剂量为20mg/m²,于第1和8天静脉注射,并在第2至7天和第9至14天给予粒细胞集落刺激因子。使用癌症治疗功能评价系统卵巢癌模块(Fact-O)评估生活质量。
49名女性患者既往化疗方案的中位数为2(范围1 - 5)。有2例完全缓解和9例部分缓解,总缓解率为24%。缓解的中位持续时间为5个月。14名女性(31%)病情稳定,缓解的中位持续时间为5个月。整个组的中位生存期为12个月。毒性主要为血液学毒性,只有3名患者因毒性而停止治疗。生活质量调查表明这是一种耐受性良好的方案。
吉西他滨和多柔比星联合用药可以安全给药。总体而言,约55%的铂耐药卵巢或腹膜癌女性患者可从该方案中获益,疾病得到缓解或病情稳定。