依维莫司治疗复发难治性骨肉瘤与软组织肉瘤的疗效评估  

Efficacy of everolimos in patients with relapsed and refractory bone and soft tissue osteosarcoma

作　　者：王雅灵[1] 周琰[1] 吴大鹏[1] 韩坤[1] 胡海燕[1] 姚阳[1] 闵大六[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200030

出　　处：《肿瘤》2016年第9期994-999,1049,共7页Tumor

摘　　要：目的：观察依维莫司治疗复发难治性骨肉瘤与软组织肉瘤的临床疗效和安全性。方法：这是一项回顾性研究。2014年1月-2015年8月收治的20例二线放化疗失败的复发难治性骨肉瘤与软组织肉瘤患者接受依维莫司治疗（10mg／次，1次／d，28d为1个治疗周期）；如患者发生不可耐受的不良反应，可减量至5rag／次，1次／d。评价依维莫司治疗的疗效和安全性。结果：20例患者中，骨肉瘤10例，软组织肉瘤10例（腺泡状软组织肉瘤2例、上皮样肉瘤2例、黏液纤维肉瘤1例、滑膜肉瘤1例、梭形细胞肉瘤1例、尤文肉瘤1例、恶性神经鞘瘤2例）。依维莫司治疗后，部分缓解5例，疾病稳定10例，疾病进展4例，疾病控制率为75％（15／20）。20例患者的中位无进展生存时间为46d（95％可信区间：29～63d），中位生存时间为56d（95%可信区间：33～79d）。10例软组织肉瘤患者和10例骨肉瘤患者的中位无进展生存时间分别为35d和56d，中位生存时间分别为84d和140d。主要的不良反应包括口腔炎（80％）、胃肠反应（30％）、皮疹（25％）和乏力（25％）。结论：依维莫司治疗复发难治性骨肉瘤与软组织肉瘤可取得一定的疗效，不良反应较轻，耐受良好。Objective： To explore the efficacy and safety of everolimus in treatment of relapsed and refractory osteosarcoma and soft tissue sarcoma. Methods： This was a retrospective study. Twenty patients with relapsed and refractory osteosarcoma and soft tissue sarcoma after failure to second-line therapy were recruited from January 2014 to August 2015. Everolimos was oral administered at a dose of 10 mg once daily, 28 days for a cycle. If the patients had untolerable side effects, the dose of everolimos was reduced to 5 mg once daily. The response and safety of everolimos were evaluated. Results： Of 20 patients, 10 patients were diagnosed of osteosarcoma, 10 patients were diagnosed of soft tissue sarcoma including 2 with acinous soft tissue sarcoma, 2 with epithelioid sarcoma, 1 with myxofibrosarcoma, 1 with synovial sarcoma, 1 with fusocellular sarcoma, 1 with Ewing sarcoma and 2 with malignant peripheral nerve sheath tumor. Five patients achieved partial response （PR）, 10 achieved stable disease （SD）, and 4 achieved progressive disease （PD）. Disease control rate was 75% （15/20）. The median progression-free survival （PFS） time and median survival time of all 20 patients were 46 days （95% confidence interval： 29-63 days） and 56 days （95% confidence interval： 33-79 days）, respectively. The median PF5 time and median survival time of 10 patients with osteosarcoma were 35 and 56 days, respectively, which of 10 patients with soft tissue sarcoma were 84 and 140 days, respectively. The main adverse effects were stomatics （80%）, rash （25%）, gastrointestinal reaction （30%） and fatigue （25%）. Conclusion： Everolimos as palliative therapy for advanced osteosarcoma and soft tissue sarcoma can achieve certain efficiency with low incidence rate of adverse reactions.

关 键 词：骨肉瘤 软组织肿瘤 依维莫司 姑息疗法 

分 类 号：R738.1[医药卫生—肿瘤]