Safra Tamar, Menczer Joseph, Bernstein Rinat Molho, Shpigel Shulem, Matcejevsky Dianna, Inbar Moshe J, Golan Abraham, Grisaru Dan, Levy Tally
Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Gynecol Oncol. 2009 Aug;114(2):215-8. doi: 10.1016/j.ygyno.2009.04.008. Epub 2009 May 14.
To evaluate safety and outcome of weekly carboplatin and paclitaxel as the initial postoperative adjuvant chemotherapy for epithelial ovarian carcinoma (EOC) patients.
Patients with stage IC-IV epithelial ovarian cancer (EOC) primary peritoneal or tubal carcinoma were enrolled in this phase II study. Intravenous carboplatin (area under the curve 2) and paclitaxel (80 mg/m(2)) were administered on days 1, 8, and 15 of a 28-day cycle for 6-8 cycles. Cytoreductive surgery was performed as primary treatment or after 3 cycles of weekly neoadjuvant chemotherapy, followed postoperatively by an additional 3 cycles of chemotherapy.
Sixty-four women (median age 65 years, range 39.9-82.8) were enrolled. Fifty-six of them (87.6%) were diagnosed with stage III-IV disease. Neutropenia was the most common hematological toxicity: 25% of the subjects had grade 3-4 neutropenia, 34.4% were supported by GCSF and 15.6% received epoetin. The majority (89%) of the patients had grade 1 and only 7.8% had grade 2 alopecia. 7.8% had grade 3 fatigue and 14.1% had grade 2 and 3.1% grade 3 neuropathy, none developed grade 4 neuropathy and only 6.3% had some residual neuropathy at >6 months after treatment. With a median follow-up of 31.5 months (range 5.9-57.3), estimated median survival was 52.0 months and median progression-free survival 25.74 (8.4-57.3) months (95% CI, 21.2-30.3). Overall and complete response rates were 92.1% and 64.1% respectively.
Weekly carboplatin and paclitaxel as the initial chemotherapy for EOC is a feasible and well tolerated regimen and should be further evaluated in a larger phase III study.
评估每周使用卡铂和紫杉醇作为上皮性卵巢癌(EOC)患者术后初始辅助化疗的安全性和疗效。
患有IC-IV期上皮性卵巢癌(EOC)、原发性腹膜癌或输卵管癌的患者参加了这项II期研究。在28天周期的第1、8和15天静脉注射卡铂(曲线下面积为2)和紫杉醇(80mg/m²),共进行6-8个周期。减瘤手术作为主要治疗方法或在3个周期的每周新辅助化疗后进行,术后再进行3个周期的化疗。
64名女性(中位年龄65岁,范围39.9-82.8岁)入组。其中56名(87.6%)被诊断为III-IV期疾病。中性粒细胞减少是最常见的血液学毒性:25%的受试者出现3-4级中性粒细胞减少,34.4%接受了粒细胞集落刺激因子支持,15.6%接受了促红细胞生成素治疗。大多数(89%)患者为1级脱发,只有7.8%为2级脱发。7.8%有3级疲劳,14.1%有2级,3.1%有3级神经病变,无患者发生4级神经病变,仅6.3%在治疗后>6个月有一些残留神经病变。中位随访31.5个月(范围5.9-57.3个月),估计中位生存期为52.0个月,中位无进展生存期为25.74(8.4-57.3)个月(95%CI,21.2-30.3)。总缓解率和完全缓解率分别为92.1%和64.1%。
每周使用卡铂和紫杉醇作为EOC的初始化疗是一种可行且耐受性良好的方案,应在更大规模的III期研究中进一步评估。