Lee Myung-Won, Ryu Hyewon, Song Ik-Chan, Yun Hwan-Jung, Jo Deog-Yeon, Ko Young Bok, Lee Hyo-Jin
Department of Internal Medicine.
Department of Obstetrics and Gynecology, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Medicine (Baltimore). 2020 Apr;99(17):e19931. doi: 10.1097/MD.0000000000019931.
The aim of this study was to evaluate the outcomes of patients with advanced or recurrent ovarian cancer treated with cisplatin combined with topotecan as second- or higher-line palliative chemotherapy.We retrospectively reviewed the medical records of patients with advanced or recurrent ovarian cancer, who were treated with cisplatin (50 mg/m on day 1) and topotecan (0.75 mg/m on days 1-3). Treatment response, progression-free survival (PFS) and overall survival (OS) were analyzed, and laboratory data were reviewed to evaluate toxicities.Thirty one patients were treated with cisplatin and topotecan. The objective response rate (ORR) was 22.6%, and the disease control rate (DCR) was 61.3%. The median PFS was 3.7 months (95% confidence interval [CI], 2.3-5.2 months) and the median OS was 44.5 months (95% CI, 35.5-53.5 months). The ORR (33.3% vs. 0%; P = .012) was significantly better in the platinum-sensitive group compared to the platinum-resistant group. The median PFS was significantly longer in the platinum-sensitive group compared to the platinum-resistant group (7.7 vs 2.5 months; P < .001), and the median OS was also significantly longer in the platinum-sensitive group (46.6 vs 19.3 months; P < .001). Almost all of the patients reported some degree of hematological toxicity. A high rate of grade 3-4 neutropenia (87.1%) was observed. Grade 3-4 thrombocytopenia (41.9%) and febrile neutropenia (19.4%) were also seen.The results showed that cisplatin combined with topotecan, as second- or higher-line palliative chemotherapy for patients with advanced or recurrent ovarian cancer, might be effective, especially in the platinum-sensitive group. However, attention should be paid to the high hematological toxicity associated with this drug combination.
本研究的目的是评估顺铂联合拓扑替康作为二线或更高线姑息化疗方案治疗晚期或复发性卵巢癌患者的疗效。我们回顾性分析了晚期或复发性卵巢癌患者的病历，这些患者接受了顺铂（第1天50mg/m²）和拓扑替康（第1 - 3天0.75mg/m²）治疗。分析了治疗反应、无进展生存期（PFS）和总生存期（OS），并审查实验室数据以评估毒性。31例患者接受了顺铂和拓扑替康治疗。客观缓解率（ORR）为22.6%，疾病控制率（DCR）为61.3%。中位PFS为3.7个月（95%置信区间[CI]，2.3 - 5.2个月），中位OS为44.5个月（95%CI，35.5 - 53.5个月）。铂敏感组的ORR（33.3%对0%；P = 0.012）显著优于铂耐药组。铂敏感组的中位PFS显著长于铂耐药组（7.7对2.5个月；P < 0.001），铂敏感组的中位OS也显著更长（46.6对19.3个月；P < 0.001）。几乎所有患者都报告了一定程度的血液学毒性。观察到3 - 4级中性粒细胞减少的发生率很高（87.1%）。还出现了3 - 4级血小板减少（41.9%）和发热性中性粒细胞减少（19.4%）。结果表明，顺铂联合拓扑替康作为晚期或复发性卵巢癌患者的二线或更高线姑息化疗方案可能有效，尤其是在铂敏感组。然而，应注意这种药物组合相关的高血液学毒性。
