铂耐药复发卵巢癌经验用药与三磷酸腺苷-肿瘤体外药敏试验指导下用药的对比研究  

Comparative Study on Empirical Medication and Medication under the Guidance of ATP-TCA in the Treatment of Platinum Resistant Recurrent Ovarian Cancer

作　　者：王建新[1] 

机构地区：[1]南阳医学高等专科学校第一附属医院肿瘤内科2病区,河南南阳473058

出　　处：《中国药房》2016年第17期2394-2397,共4页China Pharmacy

摘　　要：目的：对比经验用药与三磷酸腺苷-肿瘤体外药敏试验（ATP-TCA）指导下用药治疗铂耐药复发卵巢癌的临床疗效、患者生存状况及不良反应发生情况。方法：90例铂耐药复发卵巢癌患者按照入院先后顺序分为药敏组（46例）和对照组（44例）。对照组患者根据临床经验,采用吉西他滨＋异环磷酰胺＋多柔比星进行化疗;药敏组患者根据ATP-TCA检测结果有针对性地确定化疗方案。两组均以28 d为1个疗程,化疗2~6个疗程。比较两组患者的化疗效果、生存状况及不良反应发生情况。结果：药敏组中,18例患者采用紫杉醇、14例患者采用多柔比星、6例患者采用紫杉醇＋长春瑞滨、5例患者采用吉西他滨、3例患者采用托泊替康。治疗后,药敏组患者的总有效率为58.70%,明显高于对照组（36.96%）,差异有统计学意义（P〈0.05）;药敏组患者的无进展生存期和中位生存期均明显长于对照组,半年生存率与1年生存率均明显高于对照组,差异均有统计学意义（P〈0.05）。药敏组患者的不良反应发生率为82.61%,对照组为80.43%,组间比较差异无统计学意义（P〉0.05）。结论：根据ATP-TCA检测结果,有针对性地为铂耐药复发卵巢癌患者制订化疗方案,其化疗效果以及患者的生存情况均优于临床经验用药,且不会提高不良反应发生率。OBJECTIVE：To compared with empirical medication and medication under the guidance of adenosine triphosphate-tumor chemosensitivity assay（ATP-TCA） in the treatment of platinum resistance recurrent ovarian cancer,and to explore clinical efficacy,survival situation of the occurrence of ADR. METHODS：90 cases of platinum resistant recurrent ovarian cancer were divided into drug sensitive group（46 cases）and control group（44 cases）according to admission order. According to clinical experience,control group was given gemcitabine ＋ ifosfamide ＋ doxorubicin for chemotherapy;according to the ATP-TCA test results,chemotherapy plan of drug sensitive group was determined. A treatment course of 2 groups lasted for 28 d,and both received2-6 courses of chemotherapy. Chemotherapy efficacy,survival situation and the occurrence of ADR were compared between 2groups. RESULTS：18 cases receiving paclitaxel,14 cases receiving doxorubicin,6 cases paclitaxe＋vinorelbine,5 cases gemcitabine,3 cases topotecan in the drug sensitive group. The total effective rate of drug sensitive group was 58.70%,which was significantly higher than that（36.96%）of control group,with statistical significance（P〈0.05）. The progression free survival and median survival of drug sensitive group were significantly longer than those of control group,and half year survival rate and 1-year survival rate were higher than control group,with statistical significance（P〈0.05）. The incidence of ADR was 82.61% in drug sensitive group and 80.43% in control group,without statistical significance（P〉0.05）. CONCLUSIONS：According to ATP-TCA test results,chemotherapy efficacy and survival situation of patients with platinum resistant recurrent ovarian cancer receiving targeted chemotherapy regimen are better than those receiving clinical empirical medication,and the incidence of ADR will not be influenced.

关 键 词：铂耐药复发卵巢癌 经验用药 三磷酸腺苷-肿瘤体外药敏试验 化疗效果 生存率 

分 类 号：R73[医药卫生—肿瘤]