拓扑替康1次/周治疗难治性复发性卵巢上皮癌的效果  

Weekly topotecan in heavily pretreated patients with recurrent epithelial ovarian carcinoma

作　　者：O' Malley D.M. Azodi M. Makkenchery A. 张丽娟 

机构地区：[1]Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, PO Box 208063, New Haven, CT 06520, United States

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2005年第12期47-48,共2页Core Journal in Obstetrics/Gynecology

摘　　要：Objective. To investigate weekly topotecan in heavily pretreated patients with recurrent ovarian cancer. Methods. The records of patients with recurrent epithelial ovarian cancer who were treated with weekly topotecan after failure of ≥ 1 prior regimen were reviewed. Patients received topotecan (median starting dose 2.5 mg/m2) on days 1, 8, and 15 of a 28- day cycle. Antitumor response was assessed after 2 cycles by serial CA- 125 levels. Results. Thirty-five heavily pretreated patients received a mean of 5 cycles of topotecan (range, 1- 13 cycles)- . Thirty-two patients had definable platinum sensitivity (16 sensitive, 8 resistant, 8 refractory). Median age was 56 years. A total of 177 cycles (534 weeks) of topotecan was administered. Hematologic toxicity was generally mild, and no grade 4 toxicities were observed. Grade 3 hematologic toxicity, including leukopenia, neutropenia, thrombocytopenia, and anemia, was observed in 2, 2, 1, and 0 patients, respectively. No patients experienced grade 3 or 4 nonhematologic toxicity. Based on serial CA- 125 measurements, there were 1 (3% ) complete and 5 (15% ) partial responses, with 1 of the partial responses in a patient with platinum-refractory disease. Stable disease was reported in 13 (38% ) patients, including 5 patients with platinum-resistant/refractory disease. Conclusion. Weekly topotecan demonstrates activity and is well tolerated compared with historical data with the standard 5- day schedule. Higher doses may be warranted because of the high tolerability shown for weekly topotecan. Weekly topotecan may be an appropriate treatment option for patients with recurrent ovarian cancer, especially heavily pretreated patients who might require dosing schedules with improved tolerability.Objective. To investigate weekly topotecan in heavily pretreated patients with recurrent ovarian cancer. Methods. The records of patients with recurrent epithelial ovarian cancer who were treated with weekly topotecan after failure of ≥ 1 prior regimen were reviewed. Patients received topotecan (median starting dose 2.5 mg/m2) on days 1, 8, and 15 of a 28- day cycle. Antitumor response was assessed after 2 cycles by serial CA- 125 levels. Results. Thirty-five heavily pretreated patients received a mean of 5 cycles of topotecan (range, 1- 13 cycles)- . Thirty-two patients had definable platinum sensitivity (16 sensitive, 8 resistant, 8 refractory). Median age was 56 years. A total of 177 cycles (534 weeks) of topotecan was administered. Hematologic toxicity was generally mild, and no grade 4 toxicities were observed. Grade 3 hematologic toxicity, including leukopenia, neutropenia, thrombocytopenia, and anemia, was observed in 2, 2, 1, and 0 patients, respectively. No patients experienced grade 3 or 4 nonhematologic toxicity. Based on serial CA- 125 measurements, there were 1 (3% ) complete and 5 (15% ) partial responses, with 1 of the partial responses in a patient with platinum-refractory disease. Stable disease was reported in 13 (38% ) patients, including 5 patients with platinum-resistant/refractory disease. Conclusion. Weekly topotecan demonstrates activity and is well tolerated compared with historical data with the standard 5- day schedule. Higher doses may be warranted because of the high tolerability shown for weekly topotecan. Weekly topotecan may be an appropriate treatment option for patients with recurrent ovarian cancer, especially heavily pretreated patients who might require dosing schedules with improved tolerability.

关 键 词：卵巢上皮癌 拓扑替康 复发性卵巢癌 毒性反应 水平评价 白细胞减少 历史数据 中性粒细胞 了中 

分 类 号：R737.31[医药卫生—肿瘤]