Vandenput Ingrid, Vergote Ignace, Leunen Karin, Berteloot Patrick, Neven Patrick, Amant Frédéric
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Leuven Cancer Institute, University Hospitals Leuven, Katholieke Universiteit Leuven, Herestraat 49, Leuven, Belgium.
Int J Gynecol Cancer. 2009 Aug;19(6):1147-51. doi: 10.1111/IGC.0b013e3181ad3dcb.
To evaluate the response of dose-dense paclitaxel/carboplatin (TC) patients with primarily advanced or recurrent endometrial cancer.
Six courses of paclitaxel (90 mg/m2) and carboplatinum (area under the curve, 4) on days 1 and 8 every 3 weeks were administered. Response rates were evaluated according to the response evaluation criteria in solid tumors.
Dose-dense TC was administered to 42 patients. The median age was 63.9 years (range, 41-81 years). The main histopathologic types were serous/clear cell (n = 27) and endometrioid (n = 13). The patients were divided in 2 groups: chemotherapy-naive group (n = 28, group 1) and a group with previous chemotherapy (n = 14, group 2).The responses for group 1 were as follows: 11 (39 %) complete response, 9 (32%) partial response, and 2 (7%) stable disease. The responses for group 2 were 1 (7%) complete response, 2 (14%) partial response, and 6 (43%) stable disease. Treatment-related death occurred in 1 patient (7%) because of neutropenia and nephrotoxicity.Progression-free survival for group 1 was 10 months (range, 4-19 months). At time of analysis, 57% of the patients were still alive after a median follow-up of 10 months (range, 4-21 months). Progression-free survival for group 2 was 11 months (range, 4-19 months).Because of grades 3 and 4 hematologic toxicity, treatment adjustments were as follows: 49 (18%) and 18 (19%) dose reductions (carboplatin area under the curve, 2-3), 35 (13%) and 14 (15%) dose delays, and 8 (3%) and 6 (6%) treatments were not administered on day 8 for groups 1 and 2, respectively.
Administration of dose-dense TC resulted in a response rate of 71% in chemotherapy-naive patients. Treatment modifications due to toxicity were frequent, but severe complications such as neutropenic fever occurred in a similar incidence as other reported 3-weekly regimens.
评估剂量密集型紫杉醇/卡铂(TC)方案对原发性晚期或复发性子宫内膜癌患者的疗效。
每3周的第1天和第8天给予6个疗程的紫杉醇(90mg/m²)和卡铂(曲线下面积为4)。根据实体瘤疗效评价标准评估缓解率。
42例患者接受了剂量密集型TC方案治疗。中位年龄为63.9岁(范围41 - 81岁)。主要组织病理学类型为浆液性/透明细胞型(n = 27)和子宫内膜样型(n = 13)。患者分为两组:初治化疗组(n = 28,第1组)和既往接受过化疗的组(n = 14,第2组)。第1组的缓解情况如下:完全缓解11例(39%),部分缓解9例(32%),病情稳定2例(7%)。第2组的缓解情况为:完全缓解1例(7%),部分缓解2例(14%),病情稳定6例(43%)。1例患者(7%)因中性粒细胞减少和肾毒性发生治疗相关死亡。第1组的无进展生存期为10个月(范围4 - 19个月)。在分析时,中位随访10个月(范围4 - 21个月)后,57%的患者仍存活。第2组的无进展生存期为11个月(范围4 - 19个月)。由于3级和4级血液学毒性,治疗调整如下:第1组和第2组分别有49例(18%)和18例(19%)剂量减少(卡铂曲线下面积为2 - 3),35例(13%)和14例(15%)剂量延迟,第1组和第2组分别有8例(3%)和6例(6%)未在第8天进行治疗。
剂量密集型TC方案在初治化疗患者中的缓解率为71%。因毒性进行的治疗调整很常见,但中性粒细胞减少性发热等严重并发症的发生率与其他报道的3周方案相似。