Department of Gynecological Oncology, University Hospital, Örebro, Sweden.
Int J Gynecol Cancer. 2012 Jan;22(1):47-53. doi: 10.1097/IGC.0b013e318234fa3a.
The purpose of this study was to assess the response rate, toxicity, progression-free survival, and overall survival in a series of patients with advanced-stage ovarian carcinoma treated with a first-line weekly docetaxel and 3 weekly carboplatin regimen.
All eligible patients were treated with intravenous docetaxel (30 mg/m) on days 1, 8, and 15, and carboplatin (area under the curve, 5) on day 1; every 21 days for at least 6 cycles.
One hundred six patients received at least one cycle of primary chemotherapy (median, 6.0; range, 1-9), and they were evaluable for toxicity assessment. Eighty-five patients had evaluable (measurable) disease and received at least 3 courses of chemotherapy and were evaluable for clinical response rate. The overall response rate was 78.8% (95% confidence interval, 70.1%-87.5%), and the biochemical response 92.8% (95% confidence interval, 87.2%-98.4%). The median progression-free survival was 12.0 months and the median overall survival was 35.3 months. Thirty-six patients (34.0%) experienced grades 3 and 4 neutropenia, which resulted in the removal of 3 patients. Six patients (5.7%) experienced grades 3 or 4 thrombocytopenia. No patients experienced grade 3 to grade 4 sensory neuropathy. Epiphora, nail changes, and fatigue were frequently recorded nonhematologic adverse effects.
The tolerable hematologic toxicity (no need for colony-stimulating factors) and the low rate of neurotoxicity (only grades 1-2) and response rates in line with the standard 3-week paclitaxel-carboplatin regimen for advanced primary ovarian carcinoma after suboptimal cytoreductive surgery make this regimen an interesting alternative in selected patients.
本研究旨在评估一系列晚期卵巢癌患者接受一线每周多西他赛和 3 周卡铂方案治疗的缓解率、毒性、无进展生存期和总生存期。
所有符合条件的患者均接受静脉注射多西他赛(30mg/m),第 1、8 和 15 天,卡铂(曲线下面积 5)第 1 天;每 21 天至少 6 个周期。
106 例患者至少接受了 1 个周期的一线化疗(中位数 6.0;范围 1-9),并可进行毒性评估。85 例患者有可评估(可测量)疾病,并接受了至少 3 个疗程的化疗,可评估临床缓解率。总缓解率为 78.8%(95%置信区间,70.1%-87.5%),生化缓解率为 92.8%(95%置信区间,87.2%-98.4%)。无进展生存期中位数为 12.0 个月,总生存期中位数为 35.3 个月。36 例(34.0%)患者发生 3 级和 4 级中性粒细胞减少症,导致 3 例患者停药。6 例(5.7%)患者发生 3 级或 4 级血小板减少症。无患者发生 3 级至 4 级感觉神经病变。溢泪、指甲改变和疲劳是经常记录的非血液学不良反应。
该方案具有可耐受的血液学毒性(无需使用集落刺激因子)和较低的神经毒性(仅 1-2 级)发生率,以及与标准的 3 周紫杉醇联合卡铂方案相当的反应率,对于亚最佳细胞减灭术后的晚期原发性卵巢癌患者来说是一种有吸引力的选择。