吉西他滨联合多西紫杉醇治疗晚期软组织肉瘤

Docetaxel and gemcitabine combination in tceatment of relapsing/refractory or advanced soft-tissue sarcomas

目的探讨吉西他滨联合多西紫杉醇治疗软组织肉瘤的疗效及毒性反应。方法 89例复发转移的晚期软组织肉瘤患者,采用吉西他滨900mg/m2静脉滴注90min,第1、8天;多西紫杉醇75mg/m2,静脉滴注60min,第8天;3周重复。分析肉瘤及5种组织学亚型患者的近期疗效、生存及影响因素。结果可评价近期疗效的82例患者中2例完全缓解,25例部分缓解,总有效率32.9%;平滑肌肉瘤和恶性纤维组织细胞瘤有效率分别为44.4%和40%,与其他组织学亚型之间差异有显著性(P=0.024)。83例患者可评价生存,1年生存率42.2%,2年生存率16.9%。结论吉西他滨联合多西紫杉醇是治疗复发转移晚期软组织肉瘤的有效方案,不同组织学亚型之间存在敏感性差异,毒性可以耐受。

Objective To determine the rfficacy and toxic effect of gemcitabine plus docetaxel in treatment of patients with soft tissue sarcoma.Methods Patients with unresectable sarcoma（n=89）were enrolled into a phase II study of gemcitabine 900 mg/m2 iv gtt on days 1 and 8 plus docetaxel 75 mg/m2 iv.gtt on day 8,repeated every 21 days.Response and survival of patients with different histology subtype of sarcoma were assessed.Results Eighty-nine patients were enrolled.Among 82 evaluable patients,complete response was observed in two patients and partial response in 25,with an overall response rate of 32.9%.The differences among five histology subtypes were significant（P=0.024）.Overall survival at 12mth and 24mth in eighty-three evaluable patients were 42.2% and 16.9%,respectively.The predominant toxicity was myelosuppression：neutropenia grade-3 was 16.9%,grade-4 was 9.0%;thrombocytopenia grade-3 was 7.9%,grade-4 was 4.5%;anemia grade-3was 2.2%,grade-4 was 2.2%.No neutropenic fever and treatment-related death occurred.Conclusion Gemcitabine plus docetaxel is tolerable and highly effective in treatment of patients with soft-tissue sarcoma,especially the subtypes such as leiomyosarcoma and malignant fibrous histiocytoma.