Nagao Shoji, Nishikawa Tadaaki, Hanaoka Tatsuya, Kurosaki Akira, Iwasa Norihiro, Hasegawa Kosei, Fujiwara Keiichi
Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi-city, Hyogo
Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka-city, Saitama.
Jpn J Clin Oncol. 2014 Nov;44(11):1040-4. doi: 10.1093/jjco/hyu124. Epub 2014 Sep 2.
We evaluated the feasibility of combination chemotherapy with paclitaxel, doxorubicin and cisplatin without prophylactic granulocyte colony-stimulating factor injection for intermediate-to-high-risk or recurrent endometrial cancer.
Women with histologically confirmed FIGO Stages I-II with >1/2 myometrial invasion, Stage III/IV or recurrent endometrial cancer were enrolled. Patients received intravenous doxorubicin (45 mg/m(2)), followed by cisplatin (50 mg/m(2)) on Day 1 and intravenous paclitaxel (160 mg/m(2)) on Day 2. Granisetron (75 µg) was administered depending on neutrophil counts on Days 3 and 8. Treatment was repeated every 21 days for six cycles or until disease progression or unacceptable toxicity. The primary endpoint was the completion rate of the scheduled chemotherapy; secondary endpoints were Grade 3/4 toxicity and response rate in patients with measurable lesions.
From September 2010 to December 2012, 35 women, including 7 with FIGO Stage I, 4 with Stage II, 13 with Stage III, 10 with Stage IV and 1 with recurrent endometrial cancer, were enrolled. There were 26 endometrial carcinomas (Grade 1, 16; Grade 2, 6; Grade 3, 4), 4 carcinosarcomas, 2 serous adenocarcinomas, 1 neuroendocrine carcinoma, 1 poorly differentiated carcinoma and 1 mixed carcinoma. Twenty-five patients (71%) completed six chemotherapy cycles. Grade 3/4 hematological toxicities included neutrocytopenia (97%), thrombocytopenia (6%) and anemia (34%). Three patients (9%) experienced neutropenic fever. Grade 3/4 non-hematological toxicities were observed in 13 patients. In 15 patients with evaluable lesions, the response rate was 80%.
Combination chemotherapy with paclitaxel, doxorubicin and cisplatin without prophylactic granulocyte colony-stimulating factor injection is feasible.
我们评估了对于中高危或复发性子宫内膜癌，不预防性注射粒细胞集落刺激因子而采用紫杉醇、阿霉素和顺铂联合化疗的可行性。
纳入组织学确诊为国际妇产科联盟（FIGO）Ⅰ-Ⅱ期且肌层浸润>1/2、Ⅲ/Ⅳ期或复发性子宫内膜癌的女性患者。患者于第1天接受静脉注射阿霉素（45mg/m²），随后静脉注射顺铂（50mg/m²），并于第2天接受静脉注射紫杉醇（160mg/m²）。根据第3天和第8天的中性粒细胞计数给予格拉司琼（75μg）。每21天重复治疗6个周期，或直至疾病进展或出现不可接受的毒性反应。主要终点是计划化疗的完成率；次要终点是3/4级毒性反应以及可测量病灶患者的缓解率。
2010年9月至2012年12月，共纳入35例女性患者，其中FIGOⅠ期7例、Ⅱ期4例、Ⅲ期13例、Ⅳ期10例、复发性子宫内膜癌1例。包括26例子宫内膜癌（1级16例、2级6例、3级4例）、4例癌肉瘤、2例浆液性腺癌、1例神经内分泌癌、1例低分化癌和1例混合癌。25例患者（71%）完成了6个化疗周期。3/4级血液学毒性包括中性粒细胞减少（97%）、血小板减少（6%）和贫血（34%）。3例患者（9%）发生中性粒细胞减少性发热。13例患者观察到3/4级非血液学毒性。15例有可评估病灶的患者缓解率为80%。
不预防性注射粒细胞集落刺激因子而采用紫杉醇、阿霉素和顺铂联合化疗是可行的。
Zotero 插件