足叶乙甙联合奥沙利铂二线治疗铂耐药上皮性卵巢癌  

Combination chemotherapy of etoposide plus oxaliplatin as a second- line treatment for the pa-tients with platinum-resistant epithelial ovarian cancer

作　　者：董伯升[1] 徐克友[1] 左彩莹[1] 张静[1] 董萍[1] 

机构地区：[1]河南省周口市中心医院肿瘤内科,466000

出　　处：《中国实用医刊》2017年第24期108-111,共4页Chinese Journal of Practical Medicine

摘　　要：目的 探讨足叶乙甙联合奥沙利铂化疗方案二线治疗铂耐药上皮性卵巢癌的疗效和安全性.方法 选择61例复发并对铂类药物耐药的上皮性卵巢癌患者,随机分为两组.观察组30例应用＂足叶乙甙联合奥沙利铂＂方案（足叶乙甙70 mg/m^2,静脉滴注,第1-5天,奥沙利铂100 mg/m^2,静脉滴注,d1）化疗,而对照组31例应用＂托泊替康＂单药方案（1.0 mg/m^2,静脉滴注,第1-5天）化疗,比较两组患者的疗效及常见毒性反应.结果 两组患者疗效的差异有统计学意义（P=0.011）,观察组与对照组的客观缓解率分别为46.66％、19.35％（P=0.023）,疾病控制率分别为80.00％、54.83％（P=0.036）.观察组与对照组中位无进展生存期分别为（6.00±2.13）、（3.25±1.00）个月,两组患者无进展生存期比较差异有统计学意义（P=0.015）.两组患者血液学毒性及肝功能异常差异均未见统计学意义（P〉0.05）.两组患者脱发、恶心呕吐及周围神经毒性不良反应比较差异有统计学意义（P〈0.05）,观察组患者较严重,但均无Ⅲ、Ⅳ度严重不良反应发生.结论 与托泊替康单药方案比较,足叶乙甙联合奥沙利铂方案二线治疗铂耐药上皮性卵巢癌疗效较好,毒性反应可耐受,具有临床应用价值.Objective To investigate the efficacy and safety of the combination chemotherapy of etoposide plus oxaliplatin as a second-line treatment for the patients with platinum-resistant epithelial o-varian cancer. Methods Sixty-one patients with recurrent and platinum-resistant epithelial ovarian canc-er were enrolled and divided into two groups randomly. The thirty patients in the observation group re-ceived etoposide plus oxaliplatin chemotherapy（etoposide 70 mg / m^2 ,intravenous drip,d1 - 5;oxalipla-tin,100 mg / m^2 ,ivgtt d1）and the thirty-one patients in the control group received topotecan monoche-motherapy（1.0mg/m^2 ,ivgtt,d1 - 5）. The efficacy and the common toxic reaction between the two groups were compared. Results The difference of curative effect between the two groups was statistically significant （P = 0. 011 ）. The objective response rate in observation group and control group was 46. 66%,19. 35% （P = 0. 023）and disease control rate in the two different group was 80. 00%, 54. 83%（P = 0. 036）,respectively. The median progression free survival in the observation group and the control group was （6. 00 ± 2. 13）months,（3. 25 ± 1. 00）months,respectively and the difference in progression free survival between the two groups was significant（P = 0. 015）. There was no significant difference in the hematological toxicity or abnormal liver-function between the two groups（P 〉 0. 05）. The adverse reactions of alopecia,nausea and vomiting,peripheral neurotoxicity between the two groups were all significantly different（P 〈 0. 05）and the above adverse reactions in observation group were more severe,but there were no Ⅲ-Ⅳ grade adverse reactions in the two groups. Conclusions Compared with the regimen of topotecan monochemotherapy,the regimen of etoposide plus oxaliplatin chemotherapy has better curative effect and tolerable toxicity as a second treatment for the patients with platinum-resistant epithelial ovarian cancer and it is suitable for clinical application.

关 键 词：足叶乙甙 奥沙利铂 托泊替康 上皮性卵巢癌 铂耐药 化学治疗 

分 类 号：R737.31[医药卫生—肿瘤]