Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 135-710, Republic of Korea.
Gynecol Oncol. 2010 Oct;119(1):87-91. doi: 10.1016/j.ygyno.2010.05.030. Epub 2010 Jun 26.
This retrospective study evaluates the efficacy and toxicity of topotecan, followed by cisplatin, in patients with persistent or recurrent cervical cancer.
Twenty-four patients were included in the study. Ninety-two cycles of chemotherapy were administered during the study period. Topotecan (0.75 mg/m(2)) was administered as a 30-minute infusion on 3 consecutive days, and cisplatin was given intravenously at a dose of 50 mg/m(2) over 1h on day 3 of every third week.
The median number of cycles administered was 3, with a range of 1-8 cycles per patient. There were 4 (16.7%) complete responses, 3 (12.5%) partial responses, and 5 (20.8%) stable disease. All of the patients with a complete response had received palliative radiation or surgery for pain or an isolated solitary recurrence prior to chemotherapy. There were no treatment delays of >7 days per cycle due to hematologic toxicity. There were 59 days of delay (average, 0.6 days per cycle) in 21 of 92 (22.8%) cycles and two episodes of dose reduction (cisplatin, 50% reduction) in 2 patients due to low creatinine clearance (30-60 mL/min). Overall, grade 3/4 anemia, thrombocytopenia, and neutropenia were experienced in 13.1%, 1.1%, and 18.5% of the courses, or 33.4%, 4.2%, and 45.8% of the patients, respectively.
Combination chemotherapy, consisting of topotecan on days 1-3 and cisplatin on day 3, showed a relatively low rate of hematologic toxicity, as compared with the regimen of topotecan on days 1-3 and cisplatin on day 1, as used in previous studies.
本回顾性研究评估拓扑替康序贯顺铂治疗持续性或复发性宫颈癌患者的疗效和毒性。
本研究纳入 24 例患者。研究期间共进行了 92 个周期的化疗。拓扑替康（0.75mg/m2）以 30 分钟输注的方式连续 3 天给药，顺铂于每 3 周的第 3 天以 50mg/m2 的剂量静脉滴注 1 小时。
中位化疗周期数为 3 个周期，范围为每个患者 1-8 个周期。4 例（16.7%）患者获得完全缓解，3 例（12.5%）患者部分缓解，5 例（20.8%）患者疾病稳定。所有完全缓解的患者在化疗前因疼痛或孤立性复发性疾病已接受姑息性放疗或手术。由于血液学毒性，无 1 个周期的治疗延迟超过 7 天。21 个周期（22.8%）中有 59 天延迟（平均每个周期 0.6 天），2 例患者（50%剂量减少）因肌酐清除率（30-60mL/min）降低出现顺铂剂量减少（2 例患者）。总体而言，13.1%、1.1%和 18.5%的疗程出现 3/4 级贫血、血小板减少和中性粒细胞减少，分别有 33.4%、4.2%和 45.8%的患者出现上述毒性。
与先前研究中拓扑替康第 1-3 天给药、顺铂第 1 天给药的方案相比，拓扑替康第 1-3 天给药、顺铂第 3 天给药的联合化疗方案血液学毒性相对较低。
