Gadducci A, Brunetti I, Cosio S, Giannessi P G, Genazzani A R, Conte P
Department of Gynecology and Obstetrics, University of Pisa, Italy.
Anticancer Res. 1997 Nov-Dec;17(6D):4703-8.
Cisplatin is the most active agent currently employed in epithelial ovarian cancer. A meta-analysis of the Advanced Ovarian Cancer Trialists Group suggested that in terms of immediate survival platinum-based therapy was superior to nonplatinum regimens and that regimens including cisplatin were superior to single agent cisplatin given at the same doses. Intraperitoneal cisplatin seems to offer some clinical benefit when compared to systemic cisplatin in patients with minimal residual disease after initial surgery. An overview on the role of anthracyclines using data from the Advanced Ovarian Cancer Trialists Group and the Ovarian Cancer Meta-Analysis Project suggested that the addition of doxorubicin significantly improves survival and that the size of this benefit is of a similar magnitude to that of platinum. Carboplatin and cisplatin are equiactive, and the different spectrum of toxicities could offer an appropriate criterion for the choice of the platinum analogue to use in the individual patient. At present, there is no conclusive evidence that cisplatin dose intense regimens are beneficial, and the issue of dose intensity must still be considered experimental. The combination of cisplatin + paclitaxel is able to obtain a better progression-free survival and survival than the association cisplatin + cyclophosphamide. Phase I-II trials on regimens including platinum compounds, anthracyclines and paclitaxel are currently ongoing.
顺铂是目前用于上皮性卵巢癌最有效的药物。晚期卵巢癌试验协作组的一项荟萃分析表明，就近期生存率而言，铂类为基础的治疗优于非铂类方案，且含顺铂的方案优于相同剂量的单药顺铂。对于初次手术后残留病灶极少的患者，与全身应用顺铂相比，腹腔内应用顺铂似乎具有一定临床益处。利用晚期卵巢癌试验协作组和卵巢癌荟萃分析项目的数据对蒽环类药物作用的一项综述表明，加用阿霉素可显著提高生存率，且这种益处的程度与铂类相似。卡铂和顺铂活性相当，不同的毒性谱可为个体患者选择铂类类似物提供合适的标准。目前，尚无确凿证据表明顺铂高剂量方案有益，剂量强度问题仍须视为试验性的。顺铂 + 紫杉醇联合用药比顺铂 + 环磷酰胺联合用药能获得更好的无进展生存期和总生存期。目前正在进行关于含铂化合物、蒽环类药物和紫杉醇方案的 I-II 期试验。
