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子宫内膜癌的化疗(GOGO-EM1 研究):TEC(紫杉醇、表柔比星和卡铂)是一种有效的缓解诱导和辅助治疗方法。

Chemotherapy for endometrial carcinoma (GOGO-EM1 study): TEC (paclitaxel, epirubicin, and carboplatin) is an effective remission-induction and adjuvant therapy.

机构信息

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.

出版信息

Cancer Chemother Pharmacol. 2011 Dec;68(6):1603-10. doi: 10.1007/s00280-011-1638-4. Epub 2011 May 17.

Abstract

BACKGROUND

TAP chemotherapy (paclitaxel, doxorubicin, and cisplatin) is effective for advanced and recurrent endometrial carcinoma, but has occasional severe toxicity. TEC chemotherapy (paclitaxel, epirubicin, and carboplatin) has been suggested to have less toxicity; however, the optimal dosage has yet to be determined.

PATIENTS AND METHODS

Phase I/II prospective study for TEC therapy was performed. A retrospective comparison of the prognosis between adjuvant TEC therapy and radiation for completely resected cases with risk factors was also performed.

RESULTS

The recommended dose of TEC therapy was determined to be paclitaxel 150 mg/m(2), epirubicin 50 mg/m(2), and carboplatin AUC 4. A TEC regimen at this dose level was shown to be tolerable. The response rate and median overall survival were 74% and 37 months for those with advanced primary disease (Group B) and 50% and 26 months for recurrent tumors (Group C), respectively. A retrospective comparison showed that adjuvant TEC therapy for completely resected stage III cases improved their prognosis when compared to an adjuvant radiation therapy.

CONCLUSION

TEC therapy was demonstrated to be a tolerable and effective treatment, not only as a remission-induction therapy for advanced and recurrent endometrial carcinomas but also as the adjuvant therapy.

摘要

背景

TAP 化疗(紫杉醇、多柔比星和顺铂)对晚期和复发性子宫内膜癌有效,但偶尔会出现严重的毒性。TEC 化疗(紫杉醇、表柔比星和卡铂)的毒性较小;然而,最佳剂量尚未确定。

患者和方法

进行了 TEC 治疗的 I/II 期前瞻性研究。还对有危险因素的完全切除病例的辅助 TEC 治疗与放疗的预后进行了回顾性比较。

结果

确定 TEC 治疗的推荐剂量为紫杉醇 150 mg/m2、表柔比星 50 mg/m2 和卡铂 AUC 4。该剂量水平的 TEC 方案被证明是可以耐受的。对于晚期原发性疾病(B 组),缓解率和中位总生存期分别为 74%和 37 个月,对于复发性肿瘤(C 组),缓解率和中位总生存期分别为 50%和 26 个月。回顾性比较表明,与辅助放疗相比,完全切除的 III 期病例的辅助 TEC 治疗改善了其预后。

结论

TEC 治疗被证明是一种耐受良好且有效的治疗方法,不仅可作为晚期和复发性子宫内膜癌的缓解诱导治疗,也可作为辅助治疗。

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