拓扑替康与顺铂联合方案治疗晚期复发性上皮性卵巢癌的多中心临床研究  

Multicenter clinical research of chemotherapy with topotecan and cisplatin in patients with advanced epithelial ovarian cancer

作　　者：李子庭[1] 程玺[1] 丰有吉[2] 章桂红[3] 狄文[4] 段涛[5] 孙廷慰[6] 唐美琴[1] 臧荣余[1] 蔡树模[1] 

机构地区：[1]复旦大学附属肿瘤医院妇科,上海200032 [2]复旦大学附属妇产科医院,上海200011 [3]中国福利会国际和平妇幼保健院,上海200030 [4]上海第二医科大学附属仁济医院,上海200001 [5]上海市第一妇婴保健院,上海200040 [6]上海市第一人民医院,上海200080

出　　处：《中国癌症杂志》2001年第5期447-450,共4页China Oncology

摘　　要：目的 :研究拓扑替康 (topotecan)与顺铂联合化疗治疗晚期复发性上皮性卵巢癌的疗效和毒性反应。方法 :我们于 2 0 0 0年 10月至 2 0 0 1年 6月联合应用拓扑替康 1.0mg/ (m2 ·d) ,第 1— 5天与顺铂 2 0mg/ (m2 ·d) ,第1— 3天 ,共治疗 30例晚期复发性卵巢癌。平均用药 2 .4个疗程。结果 :总有效率为 33.3% (10 / 30 ) ,其中CR 4例 ,PR 6例 ;疗效稳定为 36 .7% (11/ 30 ) ;进展为 30 .0 % (9/ 30 ) ,其中 3例于随访中死亡。至随访截止 ,中位无进展期 5月 ,中位生存期 6 .5月。毒性反应以骨髓抑制为主 ,Ⅲ—Ⅳ度白细胞下降为 5 6 .7% (17/ 30 ) ,以中性粒细胞下降为主 ;Ⅲ—Ⅳ度血小板下降为 30 .0 % (9/ 30 ) ;Ⅲ—Ⅳ度血红蛋白下降为 30 .0 % (9/ 30 )。无严重并发症发生。恶心、呕吐发生率为 86 .7% ,脱发占 83.3%。结论 :本方案抗肿瘤效应肯定 ,但血液学毒副反应较大 。Purpose:To study the therapeutic effect and toxic reaction of salvage chemotherapy with topotecan and cisplatin in patients with advanced recurrent epithelial ovarian cancer.Methods:Thirty patients entered this multicenter pilot study from October 2000 to June 2001. They received cisplatin at 20 mg/(m 2·d) from day 1 to day 3 and topotecan at 1.0 mg/(m 2·d) from day 1 to day 5 every 18 days. The average cycle was 2.4. Results:The overall response rate was 33.3 % (10/30), among which complete response was seen in 4 cases and partial response in 6 cases. 36.7 % (11/30) had stable disease and 30.0 % (9/30) had progression, 3 of them died during follow up. Until the end of the study, the median progression free interval and survival were 5 months and 6.5 months. The major toxic reaction was myelosuppression with 56.7 % of grade Ⅲ and Ⅳ neutropenia, 30.0 % (9/30) of grade Ⅲ and Ⅳ thrombocytopenia and 30.0 % (9/30) of grade Ⅲ and Ⅳ anemia. No severe complication occurred. Nausea/vomiting and alopecia occureed in 86.7 % and 83.3 % of the cases.Conclusions:This combination regimen has moderate anti tumor activity, but the hematological toxicity is great. It can be selectively used in the patients with advanced recurrent epithelial ovarian cancer as a second line chemotherapy.

关 键 词：晚期复发性上皮性卵巢肿瘤 化学治疗 拓扑替康 顺铂 药物联合治疗 

分 类 号：R737.31[医药卫生—肿瘤] R730.53[医药卫生—临床医学]