白蛋白结合型紫杉醇联合铂类治疗晚期或复发性妇科肿瘤的临床分析  

The clinical application of albumin-bound paclitaxel plus platinum-based agents in advanced or recurrent gynecological cancer

作　　者：曾靖[1] 张蓉[1] 黄曼妮[1] 安菊生[1] 白萍[1] 李巍[1] 吴令英[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院妇瘤科,北京100021

出　　处：《癌症进展》2014年第4期387-393,共7页Oncology Progress

摘　　要：目的观察白蛋白结合型紫杉醇联合铂类治疗晚期或复发性妇科肿瘤的近期疗效和副反应。方法选取晚期或复发性妇科肿瘤患者38例（宫颈癌26例,卵巢癌11例,子宫内膜癌1例）,给予白蛋白结合型紫衫醇175 mg/m^2,d1,联合铂类（奈达铂80 mg/m^2,d1;卡铂曲线下面积（AUC）=4-5,d1;奥沙利铂130 mg/m^2,d1）静脉滴注,21天为一个疗程,直至疾病进展或出现不可耐受的不良反应,2个疗程后对治疗有效的患者进行评价。结果 38例患者中33例可评价疗效,完全缓解（CR）1例（3.0%）,部分缓解（PR）15例（45.5%）,疾病稳定（SD）9例（27.3%）,疾病进展（PD）8例（24.2%）,客观有效率（ORR）48.5%,中位无进展生存时间（PFS）为5.5个月;不良反应中骨髓抑制较常见,Ⅲ级中性粒细胞减少发生率为21.1%,无Ⅳ级骨髓抑制和过敏反应。结论白蛋白结合型紫杉醇联合铂类治疗晚期或复发性妇科肿瘤的近期疗效较好,毒副反应可以耐受。Objective To observe the efficacy and side effects of albumin-bound paclitaxel（nab-PC） plus platinum-based agents in advanced or recurrent gynecological cancer. Method Between December 2009 and July 2013 in Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College, 38 patients with advanced or recurrent gynecological cancer（26 cases of cervical cancer, 11 cases of ovarian cancer and 1 cases of endometrial carcinoma） received chemotherapy of nab- PC（175 mg/m^2, d1） combined with platinum- based agents（nedaplatin 80 mg/m^2, d1, carboplatin area under the curve（AUC） = 4-5, d1 or oxaliplatin 130 mg/m^2, d1） every 21 days until disease progress or intolerable adverse reactions occurred. The efficacy was evaluated after 2 cycles. Result Among 38 patients, 33 were evaluable for efficacy. One patient（3.0%） achieved complete response（CR）,15 patients（45.5%） with partial response（PR）, 9（27.3%） patients with stable disease（SD） and 8（24.2%） patients were with progressive disease（PD）. The overall response rate（ORR） was 48.5% and the median PFS was 5.5 months.Myelosuppression was common, and incidence of grade 3 neutropenia was only 21.1% while there were no cases of grade 4 neutropenia or cases of allergic reactions. Conclusion Preliminary results suggest that nab-PC plus platinum-based chemotherapy is effective and tolerable in advanced or recurrent gynecological cancer.

关 键 词：白蛋白结合型紫杉醇 妇科肿瘤 不良反应 

分 类 号：R737.3[医药卫生—肿瘤]