Verborg W A, Campbell L R, Highley M S, Rankin E M
Division of Cancer Medicine, Biomedical Research Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom.
Int J Gynecol Cancer. 2008 Mar-Apr;18(2):228-34. doi: 10.1111/j.1525-1438.2007.00994.x. Epub 2007 May 19.
The optimal treatment of progressive ovarian cancer after first-line platinum-based therapy remains a challenge. We collected prospectively data on patients with relapsed or progressive ovarian cancer treated with weekly cisplatin and oral etoposide in our institution to evaluate the feasibility, efficacy, and toxicity of this regimen. Patients (n = 34) had stage IIIC/IV ovarian cancer, which was recurrent or progressive following previous treatment with carboplatin and a taxane. Cisplatin (50 mg/m(2)) was given days 1, 8, 15, 29, 36, and 43, with oral etoposide (50 mg daily) on days 1-15 and 29-43. Responders and those with stable disease then received oral etoposide (50 mg daily for 21 days of a 28-day cycle) until disease progression. The overall CA125 response rate was 88%. The overall radiological response rate was 57%: 78% in the platinum-sensitive group, 50% in the intermediate-sensitive group, and 46% in the platinum-resistant group. Treatment was well tolerated. Median survival in the overall group was 14 months: in the platinum-sensitive group 16.5 months, in the intermediate-sensitive group 11 months, and 10.5 months in the platinum-resistant group. We conclude that weekly cisplatin/etoposide, followed by maintenance oral etoposide, is an active and well-tolerated regimen in relapsed or progressive ovarian cancer, even in platinum-resistant patients.
一线铂类药物治疗后进展期卵巢癌的最佳治疗方案仍是一项挑战。我们前瞻性收集了在我院接受每周顺铂和口服依托泊苷治疗的复发性或进展性卵巢癌患者的数据,以评估该方案的可行性、疗效和毒性。34例患者患有IIIC/IV期卵巢癌,此前接受卡铂和紫杉烷治疗后复发或进展。顺铂(50mg/m²)于第1、8、15、29、36和43天给药,口服依托泊苷(每日50mg)于第1 - 15天和第29 - 43天给药。缓解者和病情稳定者随后接受口服依托泊苷(每28天周期中的21天每日50mg),直至疾病进展。CA125总体缓解率为88%。总体影像学缓解率为57%:铂敏感组为78%,中度敏感组为50%,铂耐药组为46%。治疗耐受性良好。总体组的中位生存期为14个月:铂敏感组为16.5个月,中度敏感组为11个月,铂耐药组为10.5个月。我们得出结论,每周顺铂/依托泊苷方案,随后维持口服依托泊苷,在复发性或进展性卵巢癌中是一种有效的且耐受性良好的方案,即使对于铂耐药患者也是如此。