Rosa Daniela D, Awada Ahmad, Mano Max S, Selleslags Jean, Lebrun Fabienne, Gil Thierry, Piccart Martine J, D'Hondt Véronique
Department of Medicine, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
Arch Gynecol Obstet. 2008 Nov;278(5):457-62. doi: 10.1007/s00404-008-0592-9. Epub 2008 Feb 14.
The prognosis of patients with platinum refractory disease is dismal. We present data from heavily pretreated patients to whom the folinic acid, 5-fluorouracil and oxaliplatin (Folfox) regimen was administered. The objectives were to assess response rate and to evaluate the safety profile.
Patients with recurrent, resistant or refractory pretreated ovarian carcinoma were eligible for oxaliplatin (85 mg/m(2)) and leucovorin (200 mg/m(2)), both given as a 2-h infusion on day 1, followed by a 48-h infusion of 5FU 2,600 mg/m(2) every 2 weeks.
Fourteen patients were treated. Median age: 56 years (49-70). Median number of previous chemotherapy regimens: 5 (3-10) and previous platinum-based regimens: 2 (1-3). Median chemotherapy-free interval (interval since the completion of the last-line chemotherapy before the administration of the Folfox regimen): 9.5 weeks (1-39). Median number of administered cycles of Folfox/patient: 8 (2-11 cycles). Two (14.5%) patients had a disease complete response, 2 (14.5%)-partial response, 4 (29%)-stable disease and 6 (43%)-progressive disease. Four (29%) patients had a CA-125 complete response, 2 (14.5%)-CA-125 partial response, 5 (35.5%)-stable CA-125 levels and 3 (21%)-progressive CA-125 levels. There were no grade 4 adverse events or deaths due to the treatment. No dose modifications were required due to toxicity.
Folfox seems to be a valuable option for heavily pre-treated patients with ovarian cancer, with an overall response rate, according to RECIST criteria, of 29% and disease stabilization in an additional 29% of patients, with a manageable toxicity profile. These results support further assessment of Folfox as salvage treatment for patients with carcinoma of the ovary or fallopian tube.
铂类难治性疾病患者的预后很差。我们展示了接受亚叶酸、5-氟尿嘧啶和奥沙利铂（Folfox）方案治疗的经过大量预处理患者的数据。目的是评估缓解率并评估安全性。
复发、耐药或难治性预处理卵巢癌患者符合接受奥沙利铂（85mg/m²）和亚叶酸钙（200mg/m²）治疗的条件，二者均在第1天静脉滴注2小时，随后每2周静脉滴注48小时的5-氟尿嘧啶2600mg/m²。
治疗了14例患者。中位年龄：56岁（49 - 70岁）。既往化疗方案的中位次数：5次（3 - 10次），既往铂类方案的中位次数：2次（1 - 3次）。中位无化疗间期（自Folfox方案给药前最后一线化疗结束后的间期）：9.5周（1 - 39周）。每位患者Folfox方案给药周期的中位次数：8次（2 - 11个周期）。2例（14.5%）患者疾病完全缓解，2例（14.5%）部分缓解，4例（29%）病情稳定，6例（43%）病情进展。4例（29%）患者CA - 125完全缓解，2例（14.5%）CA - 125部分缓解，5例（35.5%）CA - 125水平稳定，3例（21%）CA - 125水平进展。无4级不良事件或因治疗导致的死亡。无需因毒性进行剂量调整。
对于经过大量预处理的卵巢癌患者，Folfox似乎是一种有价值的选择，根据RECIST标准，总体缓解率为29%，另有29%的患者病情稳定，且毒性可控。这些结果支持进一步评估Folfox作为卵巢或输卵管癌患者的挽救治疗方案。
