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[短期住院循环大剂量顺铂治疗卵巢恶性肿瘤——增加顺铂总剂量并改善患者生活质量]

[Cyclic high dose CAP therapy by short-stay admission for ovarian malignancies--to increase total dose of CDDP and to improve quality of life of patients].

作者信息

Ochiai K, Isonishi S, Kimura E, Yokoyama S, Sasaki H, Arihiro T, Terashima Y

机构信息

Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo.

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1991 Jan;43(1):19-25.

PMID:1997612
Abstract

Since 1986, attempts have been made to improve the anti-cancer effect of Cisplatin (CDDP) in malignant ovarian tumor patients and their quality of life (QOL), by increasing single and total dose of CDDP and by short-stay cyclic treatment at our institution. In this study, the side effects of CDDP at high and low doses were compared and the effect on the QOL was analysed. Twenty ovarian malignant tumor patients who underwent adjuvant chemotherapy (CDDP 70 mg/m2, Adriamycin (ADR) 20 mg/m2, Cyclophosphamide (CPM) 200 mg/m2 given every 4 weeks for a total of 5 times and every 8-12 weeks thereafter for 5 times) after initial surgery were compared with non randomized control patients who received the old regimen of of our institution (CDDP 35 mg/m2, ADR 20 mg/m2, CRP 200 mg/m2, 5-FU 150 mg/m2 for 5 days given every 4 weeks for a total of 5 times without discharge from hospital). There was no significant difference between the groups in the white blood cell (WBC) count and creatinine clearance (Ccr) throughout the treatment, although a slight drop was observed after the second course in both groups. The QOL was examined by interviewing the patients on their physical and mental condition. Although the total amount of CDDP was increased from 175 mg/m2 to as much as 700 mg/m2, no severe nephrotoxicity or myelosuppression was seen and patients felt better and preserved a good QOL during a short hospital stay. These results clearly indicate the efficacy of our new regimen.

摘要

自1986年以来,我院尝试通过增加顺铂(CDDP)的单次剂量和总剂量以及短期循环治疗,来提高恶性卵巢肿瘤患者中顺铂的抗癌效果及其生活质量(QOL)。在本研究中,比较了高剂量和低剂量CDDP的副作用,并分析了其对生活质量的影响。将20例卵巢恶性肿瘤患者在初次手术后接受辅助化疗(CDDP 70 mg/m²,阿霉素(ADR)20 mg/m²,环磷酰胺(CPM)200 mg/m²,每4周给药1次,共5次,此后每8 - 12周给药1次,共5次)的情况,与接受我院旧方案(CDDP 35 mg/m²,ADR 20 mg/m²,CRP 200 mg/m²,5 - FU 150 mg/m²,持续5天,每4周给药1次,共5次,住院期间给药)的非随机对照患者进行比较。在整个治疗过程中,两组患者的白细胞(WBC)计数和肌酐清除率(Ccr)没有显著差异,尽管两组在第二个疗程后均观察到略有下降。通过询问患者的身体和精神状况来检查生活质量。尽管CDDP的总量从175 mg/m²增加到了700 mg/m²之多,但未观察到严重的肾毒性或骨髓抑制,患者感觉良好,并且在短时间住院期间保持了良好的生活质量。这些结果清楚地表明了我们新方案的有效性。

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