静脉与腹腔内化疗治疗Ⅲ期卵巢癌和原发腹膜癌的Ⅲ期试验中的腹腔内导管效果:一项妇科肿瘤协作组研究  

Intraperitoneal catheter outcomes in a phase III trial of intravenous versus intraperitoneal chemotherapy in optimal stage III ovarian and primary peritoneal cancer:A Gynecologic Oncology Group study

作　　者：Walker J.L. ArmstrongD.K. 李奎 

机构地区：[1]Department of Obstetrics and Gynecology, University of Oklahoma, PO Box 26901, Oklahoma City, OK 73190, United States

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2006年第6期45-45,共1页Core Journal in Obstetrics/Gynecology

摘　　要：Objectives. To evaluate reasons for discontinuing intraperitoneal (IP) chemotherapy, and to compare characteristics of patients who did versus did not successfully complete six cycles of IP chemotherapy. Methods. In a phase III trial, women with optimal stage III ovarian or peritoneal carcinoma were randomly allocated to receive IP therapy (paclitaxel 135 mg/m2 intravenously (IV) over 24 h, cisplatin 100 mg/m2 IP day 2, paclitaxel 60 mg/m2 IP day 8) every 21 days for six cycles. Patients unable to receive IP therapy were treated with the alternate (IV) regimen. Variables compared included surgical procedures prior to enrollment, timing of IP catheter insertion, and primary and contributing reasons for discontinuing IP therapy. Results. Among 205 eligible patients randomly allocated to the IP arm, 119 (58% ) did not complete six cycles of IP therapy. Forty (34% ) patients discontinued IP therapy primarily due to catheter complications and 34 (29% ) discontinued for unrelated reasons. Hysterectomy, appendectomy, small bowel resection, and ileocecal resection were not associated with failure to complete six cycles. IP therapy was not initiated in 16% of patients who did versus 5% of those who did not have a left colon or rectosigmoid colon resection (P = 0.015). There was no association between timing of catheter insertion and failure to complete IP therapy. Conclusions. In this multi- institutional setting, it was difficult to deliver six cycles of IP therapy without complications. There appears to be an association between rectosigmoid colon resection and the inability to initiate IP therapy. Catheter choice, timing of insertion, and how surgical treatment of ovarian cancer influences the successful completion of intraperitoneal chemotherapy require further study.Objectives. To evaluate reasons for discontinuing intraperitoneal （IP） chemotherapy, and to compare characteristics of patients who did versus did not successfully complete six cycles of IP chemotherapy. Methods. In a phase Ⅲ trial, women with optimal stage Ⅲ ovarian or peritoneal carcinoma were randomly allocated to receive IP therapy （paclitaxel 135 mg/m^2 intravenously （Ⅳ）over 24 h, cisplatin 100 mg/m^2 IP day 2, paclitaxel 60 mg/m^2 IP day 8） every 21 days for six cycles. Patients unable to receive IP therapy were treated with the alternate （Ⅳ） regimen. Variables compared included surgical procedures prior to enrollment, timing of IP catheter insertion, and primary and contributing reasons for discontinuing IP therapy. Results. Among 205 eligible patients randomly allocated to the IP arm, 119 （58%） did not complete six cycles of IP therapy. Forty （34%） patients discontinued IP therapy primarily due to catheter complications and 34 （29%） discontinued for unrelated reasons. Hysterectomy, appendectomy, small bowel resection, and ileocecal resection were not associated with failure to complete six cycles. IP therapy was not initiated in 16% of patients who did versus 5% of those who did not have a left colon or rectosigmoid colon resection （P = 0. 015）. There was no association between timing of catheter insertion and failure to complete IP therapy. Conclusions. In this multi-institutional setting, it was difficult to deliver six cycles of IP therapy without complications.

关 键 词：化疗治疗 Ⅲ期试验 内导管 腹腔内 腹膜癌 卵巢癌 妇科肿瘤 化疗患者 子宫切除术 协作 

分 类 号：R730.53[医药卫生—肿瘤] R979.1[医药卫生—临床医学]