Second Division of Medical Oncology, Department of Medicine, Metaxa Cancer Hospital, Piraeus, Greece.
Br J Cancer. 2011 Sep 27;105(7):897-902. doi: 10.1038/bjc.2011.316. Epub 2011 Aug 16.
Malignant mixed Mullerian tumours (MMMTs) of the uterus and adnexa represent aggressive gynaecologic malignancies with a high rate of loco-regional and distant failure. For that reason, we evaluated the paclitaxel-ifosfamide-carboplatin (TICb) combination in patients with advanced MMMTs.
Female patients with advanced MMMTs, WHO-PS 0-2, no prior chemotherapy for systemic disease, unimpaired haemopoietic and organ function were eligible. Chemotherapy was administered at the following doses; paclitaxel: 175 mg m(-2) on day 1, ifosfamide: 2.0 g m(-2) day(-1)--days 1 and 2, and carboplatin at a target area under the curve 5 on day 2, with prophylactic G-CSF from day 3.
Forty patients of a median age 61 (45-72) years, performance status 0-2 with advanced MMMTs of the uterus (n=34), tubes (n=2) or ovary (n=4) have entered and all were evaluable for response and toxicity. Responses were as follows: 27 out of 40 (67.5%) evaluable patients responded, with 11 complete responses and 16 partial responses, while 10 had stable disease, and 3 developed progressive disease. The median response duration was 9 months (range, 4-40 months), median progression-free survival 13 months (range, 3-42 months), while median overall survival 18 months (range, 4-48 months). Grade 3/4 neutropenia was recorded in 22 out of 40 (55%)--with 13 developing grade 4 (≤7 days) and 7 out of 40 (17.5%) of patients at least one episode of febrile neutropenia.
In this study, it appears that the TICb combination, yielded important activity with manageable toxicity in females with advanced MMMTs warranting further randomised comparison with current standard regimens.
子宫和附件的恶性混合 Müllerian 肿瘤（MMMT）是一种具有高局部复发和远处转移率的侵袭性妇科恶性肿瘤。因此，我们评估了紫杉醇-异环磷酰胺-卡铂（TICb）联合治疗晚期 MMMT 患者的疗效。
本研究纳入了晚期 MMMT、WHO 表现状态 0-2、无全身化疗史、造血和器官功能未受损的女性患者。化疗方案为：紫杉醇 175mg/m²，第 1 天；异环磷酰胺 2.0g/m²，第 1-2 天；卡铂 AUC 为 5，第 2 天，从第 3 天开始预防性使用 G-CSF。
40 名年龄中位数为 61 岁（45-72 岁）、表现状态 0-2 的晚期 MMMT 患者入组，其中子宫（n=34）、输卵管（n=2）或卵巢（n=4）。所有患者均可评估疗效和毒性。结果显示，40 例可评估患者中，27 例（67.5%）有缓解，其中 11 例完全缓解，16 例部分缓解，10 例疾病稳定，3 例疾病进展。中位缓解持续时间为 9 个月（范围 4-40 个月），中位无进展生存期为 13 个月（范围 3-42 个月），中位总生存期为 18 个月（范围 4-48 个月）。40 例患者中，22 例（55%）出现 3/4 级中性粒细胞减少症，其中 13 例（32.5%）发生 4 级（≤7 天）中性粒细胞减少症，7 例（17.5%）发生至少 1 次发热性中性粒细胞减少症。
在这项研究中，TICb 联合方案在晚期 MMMT 女性患者中表现出重要的疗效，且毒性可耐受，值得与目前的标准方案进行进一步的随机比较。
