聚乙二醇化脂质体阿霉素与卡铂联合治疗复发性上皮性卵巢癌
[Combined pegylated liposomal doxorubicin and carboplatin in the treatment of recurrent epithelial ovarian cancer].
作者信息
Zheng Hong, Gao Yu-Nong, Jiang Guo-Qing, Gao Min, Wang Wen, Yan Xin
机构信息
Department of Gynecologic Oncology, Beijing Cancer Hospital & Institute, Peking University School of Oncology, Beijing 100142, China.
出版信息
Zhonghua Fu Chan Ke Za Zhi. 2008 Nov;43(11):839-42.
OBJECTIVE
To evaluate the efficacy and toxicity of combined pegylated liposomal doxorubicin (PLD) and carboplatin in the treatment of patients with recurrent epithelial ovarian cancer.
METHODS
We retrospectively reviewed 67 patients with recurrent epithelial ovarian cancer or primary peritoneal adenocarcinoma (8 cases) who were treated with combined PLD and carboplatin. The response rate, survival and toxicity were evaluated. The mean age for 67 patients was 52.1 (39 - 76) years. All of them received cytoreductive surgery followed by platinum-based chemotherapy either with paclitaxel or cyclophosphamide and doxorubicin after diagnosis. Combined PLD and carboplatin was used as first or second-line treatment or even after multiple lines of treatment after disease recurred. Patients were treated with PLD at 35 - 40 mg/m(2) combined with carboplatin at an area under curve (AUC) of 5 once every 4 weeks.
RESULTS
Forty-nine patients were evaluable for response. Twenty-three (47%) patients had a complete response, 13 (27%) had a partial response, 3 (6%) had stable disease and 10 (20%) had progressive disease. The estimated median progression-free survival (PFS) was 8 months. The 1-year and 2-year survival rates were 73% and 55%, respectively. All of the 67 patients were evaluated for toxicity. The treatment was terminated in 2 patients due to allergic-like infusion reaction. Four patients who had acute infusion reaction with shortness of breath and tightness of chest did not terminate the treatment because no such reaction occurred when restarted the infusion. There were 2 patients with G(2) and 3 patients with G(3) hand-foot syndrome, 2 patients had G(4) stomatitis, and 8 patients had G(3) leukopenia. No G(4) leukopenia or cardiotoxicity occurred.
CONCLUSION
The combination of PLD and carboplatin is an active and well-tolerated regimen in the treatment of patients with recurrent epithelial ovarian cancer.
目的
评估聚乙二醇化脂质体阿霉素（PLD）与卡铂联合应用于复发性上皮性卵巢癌患者治疗的疗效和毒性。
方法
我们回顾性分析了67例接受PLD与卡铂联合治疗的复发性上皮性卵巢癌或原发性腹膜腺癌患者（其中8例为原发性腹膜腺癌）。评估了缓解率、生存率和毒性。67例患者的平均年龄为52.1岁（39 - 76岁）。所有患者在诊断后均接受了肿瘤细胞减灭术，随后接受以铂类为基础的化疗，化疗方案为紫杉醇或环磷酰胺联合阿霉素。PLD与卡铂联合治疗作为疾病复发后的一线或二线治疗，甚至在多线治疗后使用。患者接受PLD 35 - 40 mg/m²联合卡铂，曲线下面积（AUC）为5，每4周给药1次。
结果
49例患者可评估疗效。23例（47%）患者完全缓解，13例（27%）部分缓解，3例（6%）疾病稳定，10例（20%）疾病进展。估计中位无进展生存期（PFS）为8个月。1年和2年生存率分别为73%和55%。对67例患者均评估了毒性。2例患者因类过敏输注反应终止治疗。4例出现急性输注反应伴呼吸急促和胸闷的患者未终止治疗，因为重新输注时未再出现此类反应。有2例患者发生2级、3例患者发生3级手足综合征，2例患者发生4级口腔炎，8例患者发生3级白细胞减少。未发生4级白细胞减少或心脏毒性。
结论
PLD与卡铂联合是治疗复发性上皮性卵巢癌患者的一种有效且耐受性良好的方案。
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