吡喃阿霉素为基础的两药联合方案治疗复发或耐药骨肉瘤临床研究  

Evaluation of THP-based Doublet Chemotherapy As Second Line Treatment for Recurrent and Refractory High-grade Osteosarcoma

作　　者：祁伟祥[1] 汤丽娜[1] 何爱娜[1] 沈赞[1] 姚阳[1] 

机构地区：[1]上海交通大学附属第六人民医院肿瘤内科,上海200233

出　　处：《肿瘤防治研究》2012年第9期1128-1131,共4页Cancer Research on Prevention and Treatment

摘　　要：目的探讨吡喃阿霉素(pirarubicin,THP)为基础的两药联合方案治疗复发或耐药骨肉瘤患者的临床疗效及不良反应。方法 2007年1月—2010年12月间共收治30例接受吡喃阿霉素为基础两药联合方案治疗的复发或耐药的骨肉瘤患者,每隔2个化疗周期进行疗效评价。研究主要终点为总有效率(overall response rate,ORR),次要终点为总生存率(overall survival,OS),无疾病进展时间(pro-gression free survival,PFS),疾病控制率(disease control rate,DCR)及不良反应。结果所有患者均接受至少2个周期吡喃阿霉素为基础的两药联合方案治疗,总共接受90个周期化疗,中位2个周期(range2～7),总有效率(PR+CR)为10%,疾病控制率(CR+PR+SD)为40%。中位PFS期为2月(95%CI:2～12),中位OS期为12月(95%CI:4～26)。最常见的Ⅲ～Ⅳ级不良反应为白细胞减少(23.3%)和恶心呕吐等胃肠道反应(11.1%)。结论吡喃阿霉素为基础的两药联合方案治疗复发或耐药骨肉瘤患者疗效肯定,耐受性好。Objective To investigate the feasibility and efficacy of Pirarubicin（THP）-based doublet chemotherapy for refractory or recurrent high-grade osteosarcoma.Methods Between Jan.2007and Dem.2010,30patients with refractory or recurrent high-grade osteosarcoma were included in this analysis.Tumor response was usually evaluated every two chemotherapy cycles by CT/MRI scan.The primary end point was overall response rate,and secondary endpoint was progression-free survival（PFS）,overall survival（OS）and disease control rate.Results All patients were given more than 2cycles（range 2～7）,a total of 90.Overall response rate was 10%.Median time to progression-free-survival and overall survival time were 2（95%CI：2～12）and 12months（95%CI：4～26）respectively.Main severe toxicities were grade 3or 4leukopenia（23.3%）and nausea and vomiting（11.1%）.Conclusion THP-based doublet chemotherapy represents an active and well tolerated treatment for refractory or recurrent high-grade osteosarcoma patients.

关 键 词：骨肉瘤 复发 耐药 吡喃阿霉素 

分 类 号：R738.1[医药卫生—肿瘤] R730.53[医药卫生—临床医学]