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[卵巢癌腹腔内化疗的结果]

[Results of intraperitoneal chemotherapy of ovarian cancer].

作者信息

de Gramont A, Marpeau L, Demuynck B, Louvet C, Varette C, Gonzalez-Canali G, Pigné A, Herbulot P, Lagadec B, Cady J

机构信息

GERCOD, Hôpital Saint-Antoine, Paris.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1991;20(3):387-92.

PMID:1869784
Abstract

We studied a series of 42 patients with advanced ovarian cancer who received intraperitoneal chemotherapy post second-look laparotomy. High-dose cisplatin (200 mg/m2) alone or in combination with cytarabine (2 g) achieved 47% response rate. Median overall survival from second-look laparotomy was 44 months with cisplatin (36 cases), 15 months with carboplatin (600 mg/m2, 5 cases) and not reached at 3 yrs with mitoxantrone (25 mg/m2, 8 cases). Median overall and progression-free survival from second-look laparotomy were 44 and 39 months respectively in complete responders (15 cases), 20 months and 9 months where residual tumor less than 2 cm (21 cases), 22 and 12 months where tumor greater than 2 cm (6 cases). There was a significant difference in survival (P = 0.01) and progression-free survival (P = 0.002) between complete responders and patients whose tumor was less than 2 cm. Toxicity was acceptable except for carboplatin with constant grade 4 leukocytes or platelets toxicity. It was not demonstrated that high-dose intraperitoneal chemotherapy given post second-look laparotomy will improve survival in advanced ovarian cancer. Further studies of polychemotherapy or early administration are needed.

摘要

我们研究了42例晚期卵巢癌患者,这些患者在二次剖腹探查术后接受了腹腔化疗。单独使用高剂量顺铂(200 mg/m²)或与阿糖胞苷(2 g)联合使用,缓解率达到47%。二次剖腹探查术后,使用顺铂(36例)的患者中位总生存期为44个月,使用卡铂(600 mg/m²,5例)的患者为15个月,使用米托蒽醌(25 mg/m²,8例)的患者3年时未达到中位总生存期。二次剖腹探查术后,完全缓解者(15例)的中位总生存期和无进展生存期分别为44个月和39个月;残留肿瘤小于2 cm的患者(21例)分别为20个月和9个月;肿瘤大于2 cm的患者(6例)分别为22个月和12个月。完全缓解者与肿瘤小于2 cm的患者在生存期(P = 0.01)和无进展生存期(P = 0.002)方面存在显著差异。除卡铂有持续的4级白细胞或血小板毒性外,毒性是可接受的。未证明二次剖腹探查术后给予高剂量腹腔化疗能改善晚期卵巢癌患者的生存期。需要对多药化疗或早期给药进行进一步研究。

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