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多柔比星+顺铂与多柔比星+24小时紫杉醇+非格司亭治疗子宫内膜癌的III期随机试验:一项妇科肿瘤学组研究

Phase III randomized trial of doxorubicin + cisplatin versus doxorubicin + 24-h paclitaxel + filgrastim in endometrial carcinoma: a Gynecologic Oncology Group study.

作者信息

Fleming G F, Filiaci V L, Bentley R C, Herzog T, Sorosky J, Vaccarello L, Gallion H

机构信息

Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL 60637, USA.

出版信息

Ann Oncol. 2004 Aug;15(8):1173-8. doi: 10.1093/annonc/mdh316.

Abstract

BACKGROUND

This study was performed to determine whether 24-h paclitaxel plus doxorubicin and filgrastim was superior to cisplatin plus doxorubicin in patients with endometrial cancer with respect to response, progression-free survival (PFS) and overall survival (OS).

PATIENTS AND METHODS

Eligible chemotherapy-naïve patients were randomly assigned to doxorubicin 60 mg/m2 intravenously (i.v.) followed by cisplatin 50 mg/m2 i.v. (arm 1, n=157) or doxorubicin 50 mg/m2 i.v. followed 4 h later by paclitaxel 150 mg/m2 i.v. over 24 h plus filgrastim 5 microg/kg on days 3-12 (arm 2, n=160). Starting doses were reduced for prior pelvic radiotherapy and age > 65 years. Both regimens were to be repeated every 3 weeks for a maximum of seven cycles.

RESULTS

There was no significant difference in response rate (40% versus 43%), PFS (median 7.2 versus 6 months) or OS (median 12.6 versus 13.6 months) for arm 1 and arm 2, respectively. Toxicities were primarily hematological, with 54% (arm 1) and 50% (arm 2) of patients experiencing grade 4 granulocytopenia. Gastrointestinal toxicities were similar in both arms.

CONCLUSIONS

Doxorubicin and 24-h paclitaxel plus filgrastim was not superior to doxorubicin and cisplatin in terms of response, PFS or survival in advanced endometrial cancer.

摘要

背景

本研究旨在确定对于子宫内膜癌患者,24小时持续输注紫杉醇联合多柔比星及非格司亭在缓解率、无进展生存期(PFS)和总生存期(OS)方面是否优于顺铂联合多柔比星。

患者与方法

符合条件的初治化疗患者被随机分配至两组,一组为静脉注射多柔比星60mg/m²,随后静脉注射顺铂50mg/m²(第1组,n = 157);另一组为静脉注射多柔比星50mg/m²,4小时后静脉滴注紫杉醇150mg/m²,持续24小时,并在第3 - 12天给予非格司亭5μg/kg(第2组,n = 160)。对于既往接受过盆腔放疗或年龄>65岁的患者,起始剂量降低。两种方案均每3周重复一次,最多进行7个周期。

结果

第1组和第2组在缓解率(分别为40%对43%)、无进展生存期(中位值分别为7.2个月对6个月)或总生存期(中位值分别为12.6个月对13.6个月)方面均无显著差异。毒性主要为血液学毒性,第1组和第2组分别有54%和50%的患者出现4级粒细胞减少。两组的胃肠道毒性相似。

结论

在晚期子宫内膜癌的缓解率、无进展生存期或生存率方面,多柔比星联合24小时持续输注紫杉醇及非格司亭并不优于多柔比星联合顺铂。

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