卡铂联合紫杉醇治疗晚期或复发性子宫恶性混合苗勒管肿瘤。不列颠哥伦比亚癌症机构的经验。
Carboplatin plus paclitaxel for advanced or recurrent uterine malignant mixed mullerian tumors. The British Columbia Cancer Agency experience.
作者信息
Hoskins Paul J, Le Nhu, Ellard Susan, Lee Ursula, Martin Lee Ann, Swenerton Kenneth D, Tinker Anna V
机构信息
Division of Medical Oncology, Vancouver Cancer Centre, Vancouver, BC, Canada.
出版信息
Gynecol Oncol. 2008 Jan;108(1):58-62. doi: 10.1016/j.ygyno.2007.08.084. Epub 2007 Oct 23.
OBJECTIVES
Uterine MMMTs are aggressive malignancies that are rarely cured by purely local therapies. Effective chemotherapy is needed. The phase III proven, ifosfamide-based combinations are inconvenient and costly. Carboplatin and paclitaxel (CT) are easy to deliver and is effective against endometrial carcinoma and should be against MMMT (as they are now regarded as epithelial in nature).
METHODS
A review of all women with uterine MMMT treated with CT. Paclitaxel 175 mg/m2 over 3 h preceded carboplatin (AUC 5-6) every 4 weeks for 3-6 cycles+/-subsequent pelvic irradiation.
RESULTS
Twenty-eight newly diagnosed women (20 evaluable) and 12 recurrent (11 evaluable) were treated. Response rates were 60% (12 of 20, CR 5, PR 7) and 55% (6 of 11, CR 2, PR 4) with median PFS of 16 and 12 months. Dose reduction occurred in 5%, treatment delay in 10%.
CONCLUSIONS
Carboplatin-paclitaxel is effective against uterine MMMT, with similar efficacy to ifosfamide combinations. It is more convenient, less costly and easy to deliver.
目的
子宫恶性苗勒管混合瘤（MMMT）是侵袭性恶性肿瘤，单纯局部治疗很少能治愈。需要有效的化疗。已证实的基于异环磷酰胺的III期联合方案不方便且成本高。卡铂和紫杉醇（CT）给药方便，对子宫内膜癌有效，也应该对MMMT有效（因为它们现在被认为本质上是上皮性的）。
方法
回顾所有接受CT治疗的子宫MMMT患者。每4周一次，紫杉醇175mg/m²静脉滴注3小时，随后给予卡铂（AUC 5 - 6），共3 - 6个周期，±后续盆腔放疗。
结果
治疗了28例新诊断患者（20例可评估）和12例复发患者（11例可评估）。缓解率分别为60%（20例中的12例，CR 5例，PR 7例）和55%（11例中的6例，CR 2例，PR 4例），中位无进展生存期分别为16个月和12个月。5%的患者出现剂量减少，10%的患者出现治疗延迟。
结论
卡铂 - 紫杉醇对子宫MMMT有效，疗效与异环磷酰胺联合方案相似。它更方便、成本更低且给药容易。
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