Hoekstra Anna V, Hurteau Jean A, Kirschner Carolyn V, Rodriguez Gustavo C
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, NorthShore University HealthSystem, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Gynecol Oncol. 2009 Dec;115(3):377-81. doi: 10.1016/j.ygyno.2009.08.021. Epub 2009 Oct 1.
To evaluate the response rate and toxicity of a regimen comprised of monthly carboplatin and weekly paclitaxel for recurrent ovarian cancer.
We performed a retrospective chart review of patients with recurrent ovarian cancer treated between 2001 and 2006 at a single institution with carboplatin AUC 5 (day 1), and paclitaxel 80 mg/m(2) (days 1, 8, 15) of a 28-day cycle. Primary endpoints were response rate, progression-free survival and overall survival.
Twenty patients were treated with this regimen from 2001 to 2006. Stage ranged from stages IC to IV. All received intravenous platinum and taxane as their initial therapy. Histologic subtypes included papillary serous (17), carcinosarcoma (1), and clear cell (2). The median number of prior regimens was 1 (range 1-3). The overall response rate was 85.0% (15 complete responses, 2 partial responses). Patients with tumors categorized as platinum sensitive had a response rate of 93.3% (14/15) and those with tumors deemed platinum resistant had a response rate of 60.0% (3/5). The median survival has not yet been reached after a median follow-up of 28 months. Neutropenia was the only grade 3/4 toxicity, occurring in 7 patients (35.0%). Platinum hypersensitivity reactions occurred in 5 patients (25.0%) who all successfully continued treatment using a carboplatin desensitization protocol.
A monthly carboplatin and weekly paclitaxel regimen is highly active for women with recurrent platinum-sensitive and platinum-resistant epithelial ovarian cancer. The regimen is well tolerated. This pilot series demonstrates the potential for this regimen as treatment of choice among doublet first salvage regimens for patients with recurrent epithelial ovarian cancer, thus warranting multi-institutional study.
评估每月一次卡铂联合每周一次紫杉醇方案治疗复发性卵巢癌的缓解率和毒性。
我们对2001年至2006年在单一机构接受治疗的复发性卵巢癌患者进行了回顾性病历审查,采用卡铂AUC 5(第1天),紫杉醇80mg/m²(第1、8、15天),每28天为一个周期。主要终点为缓解率、无进展生存期和总生存期。
2001年至2006年有20例患者接受了该方案治疗。分期从IC期到IV期。所有患者初始治疗均接受静脉铂类和紫杉烷治疗。组织学亚型包括乳头状浆液性(17例)、癌肉瘤(1例)和透明细胞癌(2例)。既往治疗方案的中位数为1(范围1 - 3)。总缓解率为85.0%(15例完全缓解,2例部分缓解)。归类为铂敏感肿瘤的患者缓解率为93.3%(14/15),而铂耐药肿瘤患者的缓解率为60.0%(3/5)。中位随访28个月后,中位生存期尚未达到。中性粒细胞减少是唯一的3/4级毒性反应,7例患者(35.0%)出现该反应。5例患者(25.0%)发生铂类过敏反应,所有这些患者均通过卡铂脱敏方案成功继续治疗。
每月一次卡铂联合每周一次紫杉醇方案对复发性铂敏感和铂耐药上皮性卵巢癌女性具有高度活性。该方案耐受性良好。这个试点系列研究表明该方案有潜力成为复发性上皮性卵巢癌患者二线首次挽救方案中的首选治疗方法,因此值得进行多机构研究。