Markman M
Department of Hepatology/Medical Oncology, Cleveland Clinic Foundation, OH 44195.
Curr Opin Obstet Gynecol. 1993 Feb;5(1):99-104.
Recent attention has focused on evaluating those clinical situations in which intraperitoneal drug delivery may be an appropriate treatment option for patients with ovarian cancer. When employed as a second-line strategy, approximately 20% to 30% of patients with small-volume residual disease (microscopic, largest tumor mass < or = 0.5 to 1 cm in maximum diameter) at initiation of treatment are expected to achieve a surgically documented complete response with a variety of organoplatinum-based intraperitoneal regimens. However, responses are rarely observed in such patients who have failed to demonstrate tumor sensitivity to systemically delivered organoplatinum drugs, despite the presence of small-volume residual disease. Investigators at several centers are currently exploring a possible role for regional drug delivery in the initial management of selected patients (ie, small-volume disease) with ovarian cancer. A recently reported trial of intraperitoneal taxol suggests this may be an ideal drug for regional therapy of ovarian cancer due to a major pharmacokinetic advantage associated with this route of drug delivery.
最近的关注焦点在于评估那些临床情况，即对于卵巢癌患者，腹腔内给药可能是一种合适的治疗选择。当作为二线策略使用时，在治疗开始时患有少量残留疾病（显微镜下可见，最大肿瘤块最大直径≤0.5至1厘米）的患者中，预计约20%至30%使用各种基于铂类的腹腔内给药方案可实现手术记录的完全缓解。然而，尽管存在少量残留疾病，但在那些对全身给药的铂类药物未表现出肿瘤敏感性的此类患者中，很少观察到缓解情况。几个中心的研究人员目前正在探索区域给药在选定的卵巢癌患者（即少量疾病患者）初始治疗中的可能作用。最近报道的一项腹腔内紫杉醇试验表明，由于这种给药途径具有主要的药代动力学优势，它可能是卵巢癌区域治疗的理想药物。
