Markman M, Reichman B, Hakes T, Rubin S, Jones W, Lewis J L, Barakat R, Curtin J, Almadrones L, Hoskins W
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
Gynecol Oncol. 1992 Dec;47(3):353-7. doi: 10.1016/0090-8258(92)90139-a.
To evaluate the efficacy of intraperitoneal (IP) carboplatin-based therapy as salvage treatment of ovarian cancer, 46 patients with persistent or recurrent ovarian cancer following initial systemic chemotherapy were treated with a regimen of carboplatin (200-300 mg/m2) and etoposide (100 mg/m2) administered on a monthly schedule. A maximum of six courses of therapy was delivered, followed by a response laparotomy. The treatment program was well tolerated, except for bone marrow suppression, with one-quarter of patients developing platelet count depressions to < or = 50,000/mm3, and one-third experiencing hemoglobin levels of < or = 8 g/dl during treatment. Twelve (38%) of 32 patients evaluable for efficacy of the treatment program achieved a surgically documented response, including 8 (25%) complete responses. Of 25 patients whose largest tumor mass at the initiation of therapy measured < or = 0.5 cm, 11 (44%) responded, including 8 (32%) complete responses. We conclude that the IP administration of carboplatin can result in surgically documented responses when used in the salvage setting in patients with advanced ovarian cancer. The relative efficacy of carboplatin versus cisplatin when administered by the IP route to patients with ovarian cancer previously treated with platinum-based systemic therapy remains to be defined.
为评估以腹腔内(IP)卡铂为基础的治疗方案作为卵巢癌挽救性治疗的疗效,46例初始全身化疗后出现持续性或复发性卵巢癌的患者接受了卡铂(200 - 300 mg/m²)和依托泊苷(100 mg/m²)的治疗方案,每月给药一次。最多给予六个疗程的治疗,随后进行疗效评估剖腹探查术。该治疗方案耐受性良好,除骨髓抑制外,四分之一的患者血小板计数降至≤50,000/mm³,三分之一的患者在治疗期间血红蛋白水平≤8 g/dl。在可评估治疗方案疗效的32例患者中,12例(38%)获得了手术记录的缓解,包括8例(25%)完全缓解。在治疗开始时最大肿瘤肿块≤0.5 cm的25例患者中,11例(44%)有反应,包括8例(32%)完全缓解。我们得出结论,在晚期卵巢癌患者的挽救治疗中,腹腔内给予卡铂可导致手术记录的缓解。卡铂与顺铂经腹腔途径给药对先前接受铂类全身治疗的卵巢癌患者的相对疗效仍有待确定。