Denschlag D, Watermann D, Hörig K, Kissel C, Tempfer C, Gitsch G
Department of Gynecology and Obstetrics, University of Freiburg School of Medicine, Freiburg, Germany.
Anticancer Res. 2004 Mar-Apr;24(2C):1267-9.
In recurrent ovarian cancer the topoisomerase-1 inhibitor topotecan shows activity after prior treatment with platinum and taxanes. Overall response rates of up to 38% in combination with an acceptable toxicity profile have been reported. We performed a pilot study to evaluate the therapeutic efficacy and toxicity profile of a low-dose continuous infusion protocol of topotecan.
Twelve patients with recurrent ovarian cancer and a measurable lesion received a continuous infusion of topotecan (0.4 mg/m2/d) over 14 days, repeated every 28 days. All patients had at least one prior platinum-containing regimen of chemotherapy (range 1-7). Responses were evaluated by ultrasound, computed tomography (CT) scans and/or magnetic resonance imaging (MRI).
A total of 57 (median 5, range 1-12) topotecan treatment cycles were administered. The overall response rate was 2/12 (17%). Four patients had stable disease (33%), among them two patients with platinum-refractory tumors. The median time to progression was 26 (range 20-100) weeks. No grade 3 or 4 hematological toxicities were observed. However, one patient developed a grade 2 allergy leading to discontinuation of topotecan.
Treatment of recurrent ovarian cancer with low-dose continuous infusion of topotecan over 14 days demonstrated response rates comparable to other dosing schedules with minimal toxicity in a preliminary series of 12 patients.
在复发性卵巢癌中，拓扑异构酶-1抑制剂拓扑替康在先前接受铂类和紫杉烷类治疗后显示出活性。据报道，联合使用时总体缓解率高达38%，且毒性特征可接受。我们进行了一项前瞻性研究，以评估拓扑替康低剂量持续输注方案的治疗效果和毒性特征。
12例复发性卵巢癌且有可测量病灶的患者接受拓扑替康持续输注（0.4mg/m²/天），持续14天，每28天重复一次。所有患者至少接受过一种含铂化疗方案（范围为1 - 7种）。通过超声、计算机断层扫描（CT）和/或磁共振成像（MRI）评估疗效。
共进行了57个（中位数为5，范围1 - 12）拓扑替康治疗周期。总体缓解率为2/12（17%）。4例患者病情稳定（33%），其中2例为铂耐药肿瘤患者。中位疾病进展时间为26（范围20 - 100）周。未观察到3级或4级血液学毒性。然而，1例患者出现2级过敏反应，导致拓扑替康停用。
在12例患者的初步系列研究中，拓扑替康14天低剂量持续输注治疗复发性卵巢癌的缓解率与其他给药方案相当，且毒性最小。
