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[紫杉醇联合卡铂化疗治疗卵巢癌肉瘤——4例报告]

[Carcinosarcoma of the ovary treated with paclitaxel and carboplatin chemotherapy - a report of 4 cases].

作者信息

Otsuka Isao, Takaya Hisamitsu, Takagi Kiyotaka, Tanaka Ayuko, Kaseki Hanako, Izuta Chinatsu, Sato Maya, Matsuura Takuto, Suzuki Yosuke

机构信息

Dept. of Gynecology, Kameda Medical Center, Japan.

出版信息

Gan To Kagaku Ryoho. 2013 Sep;40(9):1249-53.

Abstract

Ovarian carcinosarcoma is a rare gynecologic malignancy that tends to develop in elderly women. This tumor consists of both carcinomatous and sarcomatous components and is associated with a poor prognosis. Because of its rarity, the optimal chemotherapeutic regimen to treat this tumor is yet to be determined. We report 4 cases of ovarian carcinosarcoma treated with paclitaxel/carboplatin(PC)therapy. The median age was 67 years(range, 64-72 years). Two patients with stage II c disease underwent a primary debulking surgery; one had microscopic residual and the other had<1 cm residual disease, and both patients received adjuvant PC therapy. In 2 other patients, a stage III patient and a stage IV patient, a partial response was achieved with neoadjuvant chemotherapy. They underwent an interval debulking surgery(residual disease<1 cm in both patients)followed by additional PC therapy. Recurrence developed in 3 patients except for 1 stage II c patient with microscopic residual disease. These 3 recurrences developed in the pelvis. Progression-free survival ranged 3-15 months; in the stage II c patient, disease progressed during adjuvant PC therapy. Overall survival of the 3 patients with recurrence ranged 6- 41 months. In conclusion, paclitaxel and carboplatin chemotherapy is an effective regimen for ovarian carcinosarcoma, although the duration of response is relatively short.

摘要

卵巢癌肉瘤是一种罕见的妇科恶性肿瘤,多见于老年女性。该肿瘤由癌性和肉瘤性成分组成,预后较差。由于其罕见性,治疗该肿瘤的最佳化疗方案尚未确定。我们报告了4例接受紫杉醇/卡铂(PC)治疗的卵巢癌肉瘤病例。中位年龄为67岁(范围64 - 72岁)。2例IIc期疾病患者接受了初次肿瘤细胞减灭术;1例有镜下残留,另1例残留病灶<1 cm,2例患者均接受了辅助PC治疗。另外2例患者,1例III期患者和1例IV期患者,新辅助化疗取得了部分缓解。他们接受了中间性肿瘤细胞减灭术(2例患者残留病灶均<1 cm),随后接受了额外的PC治疗。除1例有镜下残留病灶的IIc期患者外,3例患者出现复发。这3例复发均发生在盆腔。无进展生存期为3 - 15个月;IIc期患者在辅助PC治疗期间疾病进展。3例复发患者的总生存期为6 - 41个月。总之,紫杉醇和卡铂化疗是治疗卵巢癌肉瘤的有效方案,尽管缓解期相对较短。

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