两种腹腔内化疗方案治疗晚期上皮性卵巢癌的毒性和耐受性比较。
A comparison of the toxicity and tolerability of two intraperitoneal chemotherapy regimens for advanced-stage epithelial ovarian cancer.
机构信息
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; Division of Gynecologic Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
出版信息
Gynecol Oncol. 2016 Jan;140(1):36-41. doi: 10.1016/j.ygyno.2015.11.005. Epub 2015 Nov 4.
OBJECTIVES
Randomized controlled trials (RCTs) in optimally cytoreduced epithelial ovarian cancer (EOC) patients have demonstrated an impressive survival benefit of intraperitoneal (IP) platinum over intravenous (IV), but its use has been limited by significant toxicity from cisplatin. The aim of this study was to compare the toxicity and tolerability of IP cisplatin to IP carboplatin in women with optimally cytoreduced EOC.
METHODS
Retrospective analysis of 141 women with EOC who underwent optimal surgical cytoreduction followed by IV paclitaxel and IP cisplatin or IP carboplatin was performed. Toxicities of the two treatment regimens were compared. As a secondary outcome, overall survival (OS) and progression-free survival (PFS) probabilities were obtained using the Kaplan-Meier estimate; the log-rank test was used to compare survival curves.
RESULTS
Of the 141 patients, 77 (54.6%) received IP cisplatin and 64 (45.4%) received IP carboplatin. Eighty-six percent received at least 4 cycles of IP chemotherapy. IP cisplatin was associated with significantly more grade 3 nausea and vomiting (10.4% vs. 1.6%, p=0.033), grade 3 neuropathy (7.8% vs. 0%, p=0.013) and grade 2-3 neutropenia (22.1% vs. 9.4%, p=0.042). No difference in PFS (p=0.602) or OS (p=0.107) was found between the groups.
CONCLUSION
IP chemotherapy had a high completion rate in both groups of patients. IP carboplatin required a less resource intense protocol and was tolerated better than IP cisplatin with less gastrointestinal, neurologic and hematologic toxicities.
目的
在最佳减瘤的上皮性卵巢癌（EOC）患者中进行的随机对照试验（RCT）表明，腹腔内（IP）铂类药物相对于静脉内（IV）铂类药物具有显著的生存获益，但由于顺铂的毒性较大，其应用受到限制。本研究旨在比较最佳减瘤的 EOC 患者中 IP 顺铂与 IP 卡铂的毒性和耐受性。
方法
对 141 例接受 IV 紫杉醇联合 IP 顺铂或 IP 卡铂治疗的最佳减瘤的 EOC 患者进行回顾性分析。比较两种治疗方案的毒性。作为次要结局，使用 Kaplan-Meier 估计获得总生存期（OS）和无进展生存期（PFS）概率；对数秩检验用于比较生存曲线。
结果
在 141 例患者中，77 例（54.6%）接受 IP 顺铂治疗，64 例（45.4%）接受 IP 卡铂治疗。86%的患者接受了至少 4 个周期的 IP 化疗。IP 顺铂与更显著的 3 级恶心和呕吐（10.4%比 1.6%，p=0.033）、3 级神经病变（7.8%比 0%，p=0.013）和 2-3 级中性粒细胞减少症（22.1%比 9.4%，p=0.042）相关。两组患者的 PFS（p=0.602）或 OS（p=0.107）均无差异。
结论
两组患者的 IP 化疗完成率均较高。与 IP 顺铂相比，IP 卡铂所需的资源强度较低，胃肠道、神经和血液学毒性更小，耐受性更好。
Zotero 插件