Department of Obstetrics and Gynecology, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 660-8511, Japan.
Gynecol Oncol. 2011 Feb;120(2):193-7. doi: 10.1016/j.ygyno.2010.10.025. Epub 2010 Dec 22.
The optimal chemotherapy regimen for women with endometrial cancer has not been established. We assessed the feasibility, toxicity and clinical efficacy of combination triweekly carboplatin and weekly paclitaxel in women with endometrial cancer.
Eligible patients had histologically confirmed primary advanced or recurrent endometrial cancer (Group A), or had localized high-risk features (Group B). All were treated with paclitaxel 80 mg/m(2) (days 1, 8 and 15) and carboplatin AUC 5 (day 1) each 21-day cycle. A minimum of 3 cycles was planned; if 75% or more of patients were able to receive at least 3 cycles with acceptable toxicity, the regimen was declared "feasible."
Forty patients were enrolled and administered 163 cycles of therapy; 38 (95%) were chemo-naive. No patients received radiation previously. Group A (measurable disease) contained 15 patients (5 with recurrent disease, 7 receiving neo-adjuvant chemotherapy, and 3 treated adjuvantly following suboptimal cytoreduction). Group B (non-measurable disease) contained 25 patients (primary stage I:10, II:5, III:8, IV:1 and relapse 1). Hematological toxicities(G3/G4) were neutropenia (31%/33%) and thrombocytopenia (6%/0%). Reversible G3 hypersensitivity (5%) and G2 cardiotoxicity (3%) was uncommon. Thirty-one patients (78%) completed ≥3 cycles (median 4, range: 1-9). Thirteen of 15 (87%) measurable patients responded (3CR, 10PR). Eighty-seven percent of measurable patients were not progressive at 6 months. In Group A, QOL scores were significantly improved after 3 cycles of chemotherapy (p=0.037), and at the completion of chemotherapy (p=0.045). QOL scores in Group B did not change during therapy.
This combination chemotherapy is feasible and effective for endometrial cancer patients.
尚未确定子宫内膜癌患者的最佳化疗方案。我们评估了三星期一次卡铂联合每周紫杉醇治疗子宫内膜癌患者的可行性、毒性和临床疗效。
符合条件的患者具有组织学证实的原发性晚期或复发性子宫内膜癌（A 组），或具有局部高危特征（B 组）。所有患者均接受紫杉醇 80mg/m²（第 1、8 和 15 天）和卡铂 AUC5（第 1 天）治疗，每 21 天为一个周期。计划至少进行 3 个周期；如果 75%或更多的患者能够以可接受的毒性接受至少 3 个周期的治疗，则该方案被认为是“可行的”。
共纳入 40 例患者，接受了 163 个周期的治疗；38 例（95%）为初次化疗。所有患者均未接受过放疗。A 组（可测量疾病）包含 15 例患者（5 例复发性疾病，7 例接受新辅助化疗，3 例辅助治疗后肿瘤未完全切除）。B 组（不可测量疾病）包含 25 例患者（Ⅰ期：10 例，Ⅱ期：5 例，Ⅲ期：8 例，Ⅳ期：1 例，复发 1 例）。血液学毒性（G3/G4）为中性粒细胞减少症（31%/33%）和血小板减少症（6%/0%）。罕见出现可逆性 G3 过敏（5%）和 G2 心脏毒性（3%）。31 例患者（78%）完成了≥3 个周期（中位数 4 个周期，范围：1-9 个周期）。15 例可测量患者中，13 例（87%）有反应（3 例完全缓解，10 例部分缓解）。6 个月时，可测量患者中有 87%无进展。A 组患者在接受 3 个周期化疗后，生活质量评分明显改善（p=0.037），在化疗结束时（p=0.045）也有改善。B 组患者在治疗过程中生活质量评分无变化。
这种联合化疗方案对于子宫内膜癌患者是可行且有效的。
