紫杉醇与异环磷酰胺治疗妇科恶性肿瘤临床比较研究

Therapeutic effects of Palitaxel and Ifosfamide for malignant gynecological tumors

目的观察紫杉醇与异环磷酰胺治疗妇科肿瘤的疗效。方法采用紫杉醇治疗妇科恶性肿瘤37例,其中卵巢肿瘤27例,输卵管癌6例,宫颈癌3例,宫内膜癌1例。33例为术后或化疗后复发病例,4例为原发卵巢癌。异环磷酰胺（IFO）为相应时间内复发的37例妇科恶性肿瘤,其中卵巢癌30例,输卵管癌3例,宫颈癌3例,宫内膜癌1例。紫杉醇化疗前61、2 h给预防用药地塞米松、西咪替丁、苯海拉明,化疗前0.5 h给地塞米松＋甲氧氯普氨。然后紫杉醇135~150 mg/m2静注3 h（或腹腔灌注）,联合卡铂。异环磷酰胺2.0 g＋卡铂。结果紫杉醇化疗组与异环磷酰胺总体生存期分别为37个月和25个月。有效率（CR＋PR）分别为48.6%与28%,差异有统计学意义（P〈0.001）。化疗毒副反应主要是骨髓抑制与脱发。结论紫杉醇治疗卵巢癌及输卵管癌疗效好,毒副反应较轻。

Objective To compare the therapeutic effects of Palitaxel and lfosfamide for malignant gynecological tumors. Methods In the Palitaxel group, 27 cases had ovarian cancer, 6 had fallopian tube cancer, 3 had cervical can- cer, and 1 had endometrium cancer; 33 cases had been subjected to surgeries or relapsed after chemotherapies, and 4 were primary ovarian cancer. In the ifosfamide group, 30 cases had ovarian cancer, 3 had fallopian tube cancer, 3 had cervical cancer, and 1 had endometrium cancer; all had relapsed after chemotherapies. In the Palitaxel group, Palitaxel （ 135-150 mg/m^2 ） was intravenously or intraperitonially administered once every three weeks in combination with carboplatin（60 mg）. In the lfosfamide group, lfosfamide（2.0 g）was administered in combination with carboplatin（60 mg）. Antihistaminics and anti-emetic were given prior to Palitaxel. Results The overall median survival time was 25 months in the lfosfamide group and was 37 months in the Palitaxel group （P 〈0.001）. The response rate was 28% and 48.6%, respectively （ P 〈 0.001）. The major toxic effects were myelosuppression and alopecia. Conclusion Palitaxel is effective in the treatment of advanced gynecological tumors.