Numazaki Reiko, Miyagi Etsuko, Onose Ryo, Nakazawa Tsuneo, Sugiura Ken, Asukai Kunio, Nakayama Hiroki, Miyamatsu Atsushi, Okamoto Naoyuki, Hirahara Fumiki
Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Int J Clin Oncol. 2006 Jun;11(3):221-8. doi: 10.1007/s10147-005-0555-0.
As the first-line chemotherapy for epithelial ovarian cancer, the paclitaxel-carboplatin (TJ) regimen has replaced the cyclophosphamide, epirubicin, and cisplatin or carboplatin (CAP) regimen in our institutes since 1998. Both regimens were retrospectively compared for effectiveness and safety to verify the adequacy of the TJ regimen.
Women with epithelial ovarian cancer at FIGO stage Ic-IV were enrolled into the study and were assigned to either the CAP group (57 cases, from 1991 until 1998) or the TJ group (49 cases, from 1998 until 2002). The response rate, progression-free survival (PFS), and overall survival (OS) were compared in both groups. Adverse effects were also evaluated.
The TJ group received an average of 6.3 courses of paclitaxel at 170.6 mg/m2 and carboplatin with an AUC of 4.3, while the CAP group received 5.8 courses of cisplatin at 61.4 mg/m2. The response rates were 82.8% in the TJ group and 70.6% in the CAP group at stage III-IV. The median OS was 43.9 months in the TJ group and 44.3 months in the CAP group. There was no statistically significant difference in effectiveness between the two groups. Peripheral neuropathy, myalgia/arthralgia, and allergic reactions were found significantly more often in the TJ group, but every adverse effect occurring in the TJ group was clinically controllable. In contrast, renal dysfunction occurred more frequently in the CAP group.
This study demonstrated that the TJ regimen is as effective as the CAP regimen in its antitumor effect for epithelial ovarian cancer, and has controllable adverse effects.
作为上皮性卵巢癌的一线化疗方案,自1998年起,紫杉醇-卡铂(TJ)方案已在我们研究所取代了环磷酰胺、表柔比星和顺铂或卡铂(CAP)方案。对这两种方案的有效性和安全性进行回顾性比较,以验证TJ方案的适用性。
纳入国际妇产科联盟(FIGO)分期为Ic-IV期的上皮性卵巢癌女性患者,将其分为CAP组(57例,1991年至1998年)或TJ组(49例,1998年至2002年)。比较两组的缓解率、无进展生存期(PFS)和总生存期(OS)。同时评估不良反应。
TJ组平均接受6.3个疗程的紫杉醇,剂量为170.6mg/m²,卡铂曲线下面积(AUC)为4.3;而CAP组接受5.8个疗程的顺铂,剂量为61.4mg/m²。在III-IV期,TJ组的缓解率为82.8%,CAP组为70.6%。TJ组的中位OS为43.9个月,CAP组为44.3个月。两组在有效性方面无统计学显著差异。TJ组外周神经病变、肌痛/关节痛和过敏反应的发生率明显更高,但TJ组出现的每种不良反应在临床上均可控制。相比之下,CAP组肾功能不全的发生率更高。
本研究表明,TJ方案在上皮性卵巢癌的抗肿瘤效果方面与CAP方案一样有效,且不良反应可控。