拓扑替康与一种新型喜树碱类似物贝洛替康用于复发性上皮性卵巢癌化疗的疗效比较：单中心经验

Comparison of the efficacy between topotecan- and belotecan-, a new camptothecin analog, based chemotherapies for recurrent epithelial ovarian cancer: a single institutional experience.

作者信息

Kim Hee Seung, Park Noh Hyun, Kang Sokbom, Seo Sang-Soo, Chung Hyun Hoon, Kim Jae Weon, Song Yong Sang, Kang Soon-Beom

机构信息

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

出版信息

J Obstet Gynaecol Res. 2010 Feb;36(1):86-93. doi: 10.1111/j.1447-0756.2009.01101.x.

DOI:10.1111/j.1447-0756.2009.01101.x

PMID:20178532

Abstract

AIM

To compare the efficacy and toxicity between topotecan- and belotecan-based chemotherapies in recurrent epithelial ovarian cancer (EOC).

METHODS

The clinical data of 80 patients treated with topotecan- (n = 45) or belotecan- (n = 35) based chemotherapy as at least a second-line chemotherapy were reviewed retrospectively between July 2001 and December 2007. Response was evaluated using the Response Evaluation Criteria in Solid Tumours (RECIST) and serum CA-125 levels. Hematological toxicity was examined according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 2.0. Time to progressive disease (TTPD), chemotherapy-specific survival (CSS) and overall survival (OS) according to the 2 chemotherapies were evaluated by the Kaplan-Meier analysis with the log-rank test.

RESULTS

Overall response rate (ORR) was 24.4% in patients treated with topotecan-based chemotherapy, while it was 45.7% in those treated with belotecan-based chemotherapy (P = 0.046). Moreover, ORR was higher in platinum-sensitive patients treated with belotecan-based chemotherapy (58.8%) than those treated with topotecan-based chemotherapy (22.2%) (P = 0.041) although it was not significantly different in platinum-resistant patients (P = 0.471). Grade 3 or 4 anemia, neutropenia and thrombocytopenia developed in 14.8% vs 3.6%, 43.1% vs 55.6%, and 20.0% vs 12.8% of cycles in topotecan- and belotecan-based chemotherapies, respectively (P < 0.05). There were no significant difference in survival between the 2 chemotherapies.

CONCLUSIONS

In our experience, belotecan-based chemotherapy seemed to be efficient with acceptable toxicity, compared to topotecan-based chemotherapy in recurrent EOC. However, randomized controlled trials are required for the comparison of the efficacy and toxicity between topotecan- and belotecan-based chemotherapies in recurrent EOC.

摘要

目的

比较拓扑替康和倍喜康用于复发性上皮性卵巢癌（EOC）化疗的疗效和毒性。

方法

回顾性分析2001年7月至2007年12月期间接受拓扑替康（n = 45）或倍喜康（n = 35）为基础的化疗作为至少二线化疗的80例患者的临床资料。采用实体瘤疗效评价标准（RECIST）和血清CA-125水平评估疗效。根据美国国立癌症研究所通用毒性标准（NCI-CTC）2.0版检查血液学毒性。采用Kaplan-Meier分析和对数秩检验评估两种化疗方案的疾病进展时间（TTPD）、化疗特异性生存期（CSS）和总生存期（OS）。

结果

接受拓扑替康为基础化疗的患者总缓解率（ORR）为24.4%，而接受倍喜康为基础化疗的患者为45.7%（P = 0.046）。此外，接受倍喜康为基础化疗的铂敏感患者的ORR（58.8%）高于接受拓扑替康为基础化疗的患者（22.2%）（P = 0.041），尽管在铂耐药患者中差异无统计学意义（P = 0.471）。拓扑替康和倍喜康为基础的化疗周期中，3或4级贫血、中性粒细胞减少和血小板减少的发生率分别为14.8%对3.6%、43.1%对55.6%和20.0%对12.8%（P < 0.05）。两种化疗方案的生存期无显著差异。