拓扑替康治疗铂类耐药的复发性卵巢癌的临床疗效观察

Clinical efficacy of topotecan in the treatment of platinum-resistant palindromia ovarian cancer

背景与目的:卵巢癌初治后易复发是其主要的生物学特征,复发后如何进行二线化疗是目前临床上的难题,本研究旨在探讨拓扑替康(topotecan,TPT)对顺铂耐药的复发性卵巢癌患者的近、远期疗效及安全性。方法:共72例对一线含顺铂方案化疗耐药的复发性卵巢癌患者接受TPT化疗:TPT 1.25 mg/m2静脉滴注第1～5天;21 d为1个周期,治疗2个周期后评价疗效及不良反应,完全缓解(CR)或部分缓解(PR)病例继续化疗直至疾病进展或不良反应不能耐受。结果:全组病例均可评价疗效,总有效率为29.2%,中位无进展生存期(progression-free survival,PFS)和中位生存时间(survival,OS)分别为8.04和14.92个月。主要不良反应为中性粒细胞减少和白细胞减少,Ⅲ～Ⅳ度不良反应分别为43.4%和52.8%,非血液学不良反应轻微。结论:TPT单药治疗对顺铂耐药的复发性卵巢癌患者疗效肯定,不良反应可以耐受,值得临床进一步研究。

Background and purpose:Ovarian cancer is easy to recur after initial treatment.When this happens,how to administer the second round of chemotherapy is a clinical puzzle.Recent research demonstrated that topotecan(TPT) is a good choice for treatment because it has higher clinical application value.The purpose of our study was to observe the short and long-term level of efficiency and safety of TPT for usage in patients with palindromia ovarian cancer.Methods:Seventy two patients with platinum-resistant palindromia ovarian cancer used TPT(1.25 mg/m2) as a 30 minutes daily infusion for 5 straight days,every 21 days.The efficacy was evaluated after 2 cycles of chemotherapy.Patients with CR or PR received further chemotherapy until disease progression or serious toxicity.Results:All patients were evaluated for treatment efficiency.The overall response rate was 29.2%.Median duration of response was 5 months,median progression free interval was 8.04 months and median overall survival was 14.92 months.Grade Ⅲ-Ⅳ leucopenia occurred in 43.4% of the patients while neutropenia occurred in 52.8% of the patients.Non-hematological toxicities were mild.There were no deaths during treatment.Conclusion:TPT is an effective and well-tolerated in the treatment of palindromia ovarian cancer and should be further studied.