Seski J C, Edwards C L, Herson J, Rutledge F N
Obstet Gynecol. 1982 Feb;59(2):225-8.
Twenty-six women with advanced or recurrent endometrial cancer were treated with cisplatin at a dose of 50, 70, or 100 mg/m2 every 4 weeks. An objective response was obtained in 11 of 26 patients (42%), with 10 partial responses and 1 complete response. The median duration of remission was 5 months, with a range of 2 to 11 months. The complete response lasted 8 months. Five patients had stable disease lasting an average of 5 months. One of 6 patients (16.6%) responded to cisplatin at a dose of 50 mg/m2, 4 of 7 (57%) responded to the dose of 70 mg/m2, and 6 of 13 (46%) responded to the dose of 100 mg/m2, but the differences were not statistically significant (P = .2). In 8 of 26 cases (31%) cisplatin was discontinued because of toxicity. Three patients developed a peripheral neuropathy, 1 patient refused further therapy because of vomiting, 2 patients had nephrotoxicity, and 2 others had both nephrotoxicity and neurotoxicity. The average total cumulative dose of cisplatin administered when renal deterioration and neuropathy occurred was approximately 500 mg/m2. Cisplatin is definitely active against endometrial cancer, but toxicity precludes its prolonged administration in high doses on an outpatient basis. By maintaining a forced diuresis, toxicity can probably be decreased, thereby permitting continued administration of cisplatin. The drug may also be more useful when used at a lower dose in combination with other active agents against endometrial cancer.
26例晚期或复发性子宫内膜癌女性患者接受顺铂治疗,剂量为50、70或100mg/m²,每4周一次。26例患者中有11例(42%)获得客观缓解,其中10例部分缓解,1例完全缓解。缓解的中位持续时间为5个月,范围为2至11个月。完全缓解持续了8个月。5例患者病情稳定,平均持续5个月。6例患者中有1例(16.6%)对50mg/m²剂量的顺铂有反应,7例中有4例(57%)对70mg/m²剂量有反应,13例中有6例(46%)对100mg/m²剂量有反应,但差异无统计学意义(P = 0.2)。26例中有8例(31%)因毒性而停用顺铂。3例患者出现周围神经病变,1例患者因呕吐拒绝进一步治疗,2例患者有肾毒性,另外2例患者既有肾毒性又有神经毒性。发生肾功能恶化和神经病变时,顺铂的平均总累积剂量约为500mg/m²。顺铂对子宫内膜癌肯定有效,但毒性使其无法在门诊长期高剂量给药。通过维持强迫利尿,毒性可能会降低,从而允许继续使用顺铂。该药物与其他抗子宫内膜癌的活性药物联合使用时,以较低剂量使用可能也更有用。