Price F V, Chambers S K, Carcangiu M L, Kohorn E I, Schwartz P E, Chambers J T
Department of Obstetrics and Gynecology, Yale University, New Haven, Connecticut 06520.
Gynecol Oncol. 1993 Dec;51(3):383-9. doi: 10.1006/gyno.1993.1308.
Thirty patients with uterine papillary serous carcinoma were treated with intravenous cisplatin, doxorubicin, and cyclophosphamide (CAP) chemotherapy, a combination with proven efficacy against ovarian carcinoma. Nineteen patients were given CAP as an adjuvant soon after surgery. Eleven patients were treated after recurrence or failure of other first-line therapy. Of the patients treated adjuvantly, 11 (58%) were alive without evidence of disease with a median follow-up of 24 months. Eight patients (42%), all with metastatic disease at diagnosis, were dead of disease (DOD) with a median survival of 14 months. In the salvage group, all patients were DOD with a median survival of 21 months from diagnosis and a median survival from initiation of CAP of 7 months. Toxicity was observed in all patients, and there was one treatment-related death from cardiotoxicity. In the salvage group there were two partial responses and one complete response (response rate = 27%). We conclude that intravenous CAP was ineffective in the treatment of metastatic or recurrent uterine papillary serious carcinoma, but deserves study as an adjuvant in patients without metastatic or with only microscopic extrauterine disease.
30例子宫浆液性乳头状癌患者接受了顺铂、阿霉素和环磷酰胺（CAP）静脉化疗，该联合化疗方案对卵巢癌已证实有效。19例患者在术后不久接受CAP辅助化疗。11例患者在其他一线治疗复发或失败后接受治疗。在接受辅助治疗的患者中，11例（58%）存活且无疾病证据，中位随访时间为24个月。8例患者（42%）均在诊断时伴有转移性疾病，死于疾病（DOD），中位生存期为14个月。在挽救治疗组中，所有患者均死于疾病，从诊断开始的中位生存期为21个月，从开始CAP治疗起的中位生存期为7个月。所有患者均观察到毒性反应，有1例因心脏毒性导致的治疗相关死亡。在挽救治疗组中有2例部分缓解和1例完全缓解（缓解率=27%）。我们得出结论，静脉CAP治疗转移性或复发性子宫浆液性乳头状癌无效，但作为无转移性或仅伴有微小宫外疾病患者的辅助治疗值得研究。
