卡铂与聚乙二醇化二硬脂酰磷脂酰胆碱脂质体阿霉素（lipo-dox®）用于复发性铂耐药或难治性上皮性卵巢癌的挽救性化疗。

Salvage chemotherapy in recurrent platinum-resistant or refractory epithelial ovarian cancer with Carboplatin and distearoylphosphatidylcholine pegylated liposomal Doxorubicin (lipo-dox®).

作者信息

Khemapech Nipon, Oranratanaphan S, Termrungruanglert W, Lertkhachonsuk R, Vasurattana A

机构信息

Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

Asian Pac J Cancer Prev. 2013;14(3):2131-5. doi: 10.7314/apjcp.2013.14.3.2131.

DOI:10.7314/apjcp.2013.14.3.2131

PMID:23679331

Abstract

BACKGROUND

To evaluate the efficacy and safety of distearoylphosphatidylcholine pegylated liposomal doxorubicin (DPLD) combined with carboplatin for the treatment of platinum resistant or refractory epithelial ovarian cancer (EOC) or fallopian tube cancer.

MATERIALS AND METHODS

A retrospective analysis of women who received DPLD with carboplatin for recurrent EOC or fallopian tube cancer in King Chulalongkorn Memorial Hospital Thailand from January 2006 to August 2011 was conducted. Patients were identified from the medical records and data on demographic factors, stage, histology, surgical findings, cytoreduction status, and prior chemotherapies were abstracted. The efficacy and toxicity of DPLD/carboplatin were evaluated. Progression-free (PFS) and overall survival (OS) were estimated by the Kaplan-Meier method.

RESULTS

A total of 65 patients, 64 with platinum resistant or refractory epithelial ovarian cancer and 1 with fallopian tube cancer, were enrolled. DPLD and carboplatin were given for an average of 4.46 cycles per patient with a total of 273 cycles. Among the 65 evaluable patients, 0% achieved CR, 7.69% PR, 15.4% SD and 76.% PD. The overall response rate was 23.1%. With a median follow-up of 27.4 months, the median progression-free and median overall survival in the 36 patients was 4.46 months and 8.76 months respectively. In the aspect of side effects, palmar-plantar erythrodysesthesia (PPE) occurred in 33.3% (Grade I 22.2%, Grade II 11.1%) and mucositis in 41.7% (Grade I 27.8%, Grade II 13.9%) of all treatment cycles, all Grade 1 or 2. Anemia, leukopenia and thrombocytopenia occurred in 58.3% (Grade I 41.7%, Grade II 16.7%), 66.7% (Grade I 47.2%, Grade II 19.4%), and 22.2% (Grade I 16.6%, Grade II 5.56%) of cycle respectively, and were mostly Grade 1 or 2.

CONCLUSIONS

DPLD, the second-generation PLD drug combined with carboplatin every 4 weeks, is effective and has low toxicity for treatment of patients with recurrent platinum-resistant or refractory epithelial ovarian cancer.

摘要

背景

评估聚乙二醇化二硬脂酰磷脂酰胆碱脂质体阿霉素（DPLD）联合卡铂治疗铂耐药或难治性上皮性卵巢癌（EOC）或输卵管癌的疗效和安全性。

材料与方法

对2006年1月至2011年8月在泰国朱拉隆功国王纪念医院接受DPLD联合卡铂治疗复发性EOC或输卵管癌的女性患者进行回顾性分析。从病历中识别患者，并提取人口统计学因素、分期、组织学、手术结果、肿瘤细胞减灭术情况及既往化疗等数据。评估DPLD/卡铂的疗效和毒性。采用Kaplan-Meier法估计无进展生存期（PFS）和总生存期（OS）。

结果

共纳入65例患者，其中64例为铂耐药或难治性上皮性卵巢癌患者，1例为输卵管癌患者。每位患者平均接受4.46周期的DPLD和卡铂治疗，共273周期。在65例可评估患者中，0%达到完全缓解（CR），7.69%达到部分缓解（PR），15.4%为疾病稳定（SD），76.%为疾病进展（PD）。总缓解率为23.1%。中位随访27.4个月，36例患者的中位无进展生存期和中位总生存期分别为4.46个月和8.76个月。在副作用方面，所有治疗周期中33.3%发生手足红斑感觉异常（PPE）（1级22.2%，2级11.1%），41.7%发生黏膜炎（1级27.8%，2级13.9%），均为1级或2级。贫血、白细胞减少和血小板减少分别在58.3%（1级41.7%，2级16.7%）、66.7%（1级47.2%，2级19.4%）和22.2%（1级16.6%，2级5.56%）的周期中出现，大多为1级或2级。