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吉西他滨挽救化疗用于紫杉烷/铂耐药复发性卵巢癌:单机构经验。

Salvage chemotherapy using gemcitabine for taxane/platinum-resistant recurrent ovarian cancer: a single institutional experience.

机构信息

Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Suita, Osaka, Japan.

出版信息

Anticancer Res. 2012 Sep;32(9):4029-33.

Abstract

BACKGROUND

The purpose of this study was to report on the safety and efficacy of gemcitabine used as salvage chemotherapy for ovarian cancer.

PATIENTS AND METHODS

From January 2002 to October 2011, 27 patients were treated with gemcitabine for platinum-resistant recurrent ovarian cancer. Gemcitabine (800 mg/m(2)) was given on days 1, 8, and 15 of every 28 days. The patients' medical records were retrospectively reviewed.

RESULTS

All 27 patients had previously received paclitaxel/carboplatin doublet and their disease had become platinum-resistant. The median number of previous chemotherapy regimens was 2 (range 1-7). A total of 114 cycles of single-agent gemcitabine were administered, with a median of 3 (range 1-10). No complete responses were observed. Partial response (PR) was observed in five patients (18.5%). Eight patients demonstrated stable disease (SD). The median duration of response for 5 responders was 4 months (range 2-6 months). The median survival time was 15 months. Patients with PR or SD (n=13) had significantly better survival compared with the group with progressive disease (n=14) (p=0.03, by univariate analysis). In addition, multivariate Cox proportional hazards analysis revealed that responses to gemcitabine were a significant factor for survival (hazard ratio=0.08, 95% confidence interval=0.0138 to 0.5614, p=0.01). Cases with hematological toxicity included 10 patients (37.0%) with grade 3/4 neutropenia, 3 patients (11.1%) with grade 3 thrombocytopenia, and 3 patients (11.1%) with grade 3 anemia. Non-hematological toxicity was well-tolerated.

CONCLUSION

Gemcitabine (800 mg/m(2)) used for recurrent ovarian cancer possesses a modest activity and a well-tolerated toxicity.

摘要

背景

本研究旨在报告吉西他滨作为挽救化疗治疗卵巢癌的安全性和有效性。

患者和方法

从 2002 年 1 月至 2011 年 10 月,27 例铂类耐药复发性卵巢癌患者接受吉西他滨治疗。吉西他滨(800mg/m²)于每 28 天的第 1、8 和 15 天给药。回顾性分析患者的病历。

结果

所有 27 例患者均曾接受紫杉醇/卡铂联合化疗,且疾病已对铂类耐药。先前化疗方案的中位数为 2 个(范围 1-7)。共给予单药吉西他滨 114 个周期,中位数为 3 个(范围 1-10)。未观察到完全缓解。5 例患者(18.5%)出现部分缓解(PR)。8 例患者表现为疾病稳定(SD)。5 例缓解患者的中位缓解持续时间为 4 个月(范围 2-6 个月)。中位总生存期为 15 个月。PR 或 SD(n=13)患者的生存时间明显优于进展性疾病(n=14)患者(p=0.03,单因素分析)。此外,多因素 Cox 比例风险分析显示,吉西他滨的反应是生存的显著因素(风险比=0.08,95%置信区间=0.0138 至 0.5614,p=0.01)。血液学毒性包括 10 例(37.0%)患者出现 3/4 级中性粒细胞减少症、3 例(11.1%)患者出现 3 级血小板减少症和 3 例(11.1%)患者出现 3 级贫血。非血液学毒性可耐受。

结论

吉西他滨(800mg/m²)用于复发性卵巢癌具有一定的活性和可耐受的毒性。

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