含铂方案中单铂改良为双铂联合治疗复发卵巢癌36例临床疗效观察

CLINICAL OBSERVATIAN OF CHANGING SINGLE-PLATINUM INTO DOUBLE-PLATINUM IN CONTAINING PLATINUM CHEMOTHERAPY ON THE TREATMENT OF 36 CASES OF OVARIAN CANCER

目的观察将含铂方案中的单铂改良为双铂联合治疗36例复发卵巢癌以达到等同的疗效和最低的毒副反应。方法经病理组织学或细胞学证实的36例复发卵巢癌患者,采用原来足量单铂联合方案应用一周期后出现较为严重的毒副反应而且出现中断化疗或延期化疗,即改为改良后的双铂联合的方案继续完成化疗,其中改良后的双铂联合的方案为顺铂60mg/m2的1/2量加生理盐水500ml于2h内静滴,第一天,卡铂AUC=5的1/2量加5%葡萄糖注射液500ml于2h内静滴,第八天,同时联合紫杉醇或吉西他滨等非铂类药物,每21d为1周期,至完成化疗后评价疗效及毒副反应和耐受性。结果 36例复发卵巢癌患者均可评价。CR5例,PR9例,总有效率(RR)66.7%。毒副反应评价:主要为骨髓抑制Ⅰ～Ⅱ;白细胞减少Ⅲ～Ⅳ5例,血小板减少Ⅲ～Ⅳ3例经相应处理后均可恢复,胃肠道反应极其轻微,无肝肾功能损害。结论将含铂方案中的单铂改良为双铂联合用于治疗复发卵巢癌与原来含单铂的标准方案比,毒副反应极轻,化疗依从性好,均按期完成预期的化疗周期数,从而使其疗效等同甚至优于原方案,值得一提的是,其极轻的毒副反应可明显改善生活质量,延长生存时间,极易于患者耐受。

Objective To evaluate the same efficacy and the lowest toxicity of changing single- Platinum into double - Platinum in containing Platinum chemotherapy on the treatment of 36 cases patients with recurrence ovarian cancer. Methods Selected 36 cases patients with recurrence ovarian cancer which were probved by histology or cytology,, which were treated with original containing cisplatin chemotherapy. then, the patient appears more serioue toxicity. So,we adopted the double- Platinum ehemotherapy：Cispla- tin half volume of 60mg/m^2 plus saline 500ml 2 hours ivgtt on dl and Carboplatin half volume of AUC = 5 plus glucose 500ml 2 hours ivgtt on d8. While jointed non- platinum drug as paclitaxel, gemcitabin and so on. The regimen was repeated every 21 days. The evaluation was performed after the boll cycles were finished. Results 36 patients had evaluative lesions. CR was observed in 9 case and PR in 15 cases,the tatal response rate（RR） was 66.7%. The main toxicity were myelosuppression, neuro- sensory toxicity and nausea/vomiting. There was no any death events during the treatment. Conclusion The double- platinum in containing platinum chemotherapy on the treatment of ovarian cancer has the same efficacy as original containing cisplatin chemotherapy. This therapeutic schedule can significantly improve life quality with the lowest toxicity. Its side effects is tolerable.