卡铂按不同药时曲线下面积给药对晚期卵巢上皮癌的疗效和安全性评价  

Evaluation on the efficacy and safety of carboplatin according to AUC in advanced ovarian cancer patients

作　　者：杜春双 包乐纹 王晨 宋晓坤 娄建石[3] 

机构地区：[1]天津肿瘤医院药学部,天津市乳腺癌防治重点实验室,天津300060 [2]天津肿瘤医院妇瘤科,天津300060 [3]天津医科大学药理教研室,天津300070

出　　处：《中国医院药学杂志》2013年第16期1344-1348,共5页Chinese Journal of Hospital Pharmacy

摘　　要：目的:分析比较不同剂量卡铂联合紫杉醇在晚期卵巢癌患者中的近期疗效、CA125指标的变化及毒副反应,以评价两方案的利弊,从而指导卡铂的合理化用药和个体化治疗。方法:选择2008年9月—2011年9月在某院住院治疗的卵巢癌患者中筛选出84例晚期(Ⅲ和Ⅳ期)上皮性卵巢癌卡铂初治患者进行回顾性分析。根据卡铂药时曲线下面积(AUC)的大小分组,观察组B组5≤AUC<7(31例)和对照组A组3≤AUC<5(53例),规范化疗2个周期以上,根据WHO统一标准进行近期疗效、CA125水平的变化及毒副反应的分析比较。结果:(1)近期疗效:通过紫杉醇联合卡铂3≤AUC<5化疗后,53例患者中总有效率(CR+PR)为47.1%,通过紫杉醇联合卡铂5≤AUC<7化疗后,31例患者中总有效率(CR+PR)为58.1%。经χ2检验,2组比较差异无显著性(P>0.05);(2)CA125水平的变化:化疗前后A组53例患者中有35例(占66.0%)血清CA125水平下降至正常水平以下(35 U.mL-1为正常临界值),而B组31例患者中有28例(占90.3%)血清CA125降至正常水平以下,经χ2检验,2组比较有显著性差异(P<0.05);(3)2组毒副作用比较:B组血液系统毒性中血小板降低发生率高于A组(P<0.05),而在白细胞降低、血红蛋白降低和中性粒细胞降低方面2组比较无显著性差异(P>0.05),非血液学毒性中胃肠道反应、神经毒性、肝和肾毒性发生率及心血管毒性2组之间无明显差异(P>0.05)。结论:紫杉醇联合卡铂5≤AUC<7(B组)的疗效要高于紫杉醇联合卡铂3≤AUC<5(A组)。OBJECTIVE To analyze and compare the recent efficacy, the changes of CA125 index and the toxic side effects of different doses of carhoplatin plus paclitaxel in advanced ovarian cancer patients; to guide rational drug use and individual thera- py with carboplatin. METHODS A total of 84 patients screened with advanced （ Ⅲ and Ⅳ） epithelial ovarian cancer from o varian cancer patients treated in Tianjin Medical University Cancer Institute and Hospital from September 2009 to September 201l were retrospectively analyzed. All patients received ovarian cytoreductive surgery and the postoperative pathologic exami nations were confirmed with primary epithelial ovarian cancer. The AUC of carboplatin according to the dose and creatinine val- ue was calculated. These 84 patients were divided into the observation group （Group B, 5≤AUC〈7, 31 cases）and the control group （Group A, 3≤AUC〈5, 53 cases）. Recent efficacy, CAl25 Index changes and toxic side effects after more than two normal courses were analyzed according to the standard of WHO. RESULTS （1） For paclitaxel combined with earboplatin 34 AUC〈5 chemotherapy, the total response rate （CR ＋ PR） of the 53 cases was 47. 1%; for paclitaxel combined with carbopla- tin 5≤AUC〈7 chemotherapy, the total response rate （CR ＋ PR） of the 31 cases was 58. 1%, χ2 test showed no significant difference between the two groups （P〉0. 05）. （2）After chemotherapy, CA125 levels dropped below normal level （35U/mL for the normal threshold） were observed in 35 patients of Group A （66. 0%） and 28 patients of Group B（90. 3%）. χ2 test showed a significant difference between the two groups （P〈0. 05）. （3）The incidence of blood platelet count reduction of Group B was higher than that of Group A （P〈0. 05）, but no significant differences were found in the reduction of white blood cell count, hemoglobin and neutrophils （P〈0. 05）. The two groups had no significant difference in gastrointestinal reaction, neurotoxicity,

关 键 词：卡铂 药时曲线下面积 卵巢上皮癌 疗效 毒性 

分 类 号：R979.1[医药卫生—药品]