紫杉醇治疗卵巢上皮性癌57例分析

Treatment of Epithelial Ovarian Cancer with Paclitaxel-based Chemotherapy

[目的]了解以紫杉醇为主的化疗方案对难治性卵巢上皮性癌患者的疗效、毒性反应以及简化化疗前预用药方法的可能性。[方法]回顾分析了1994年7月1日至2000年12月31日收治的57例卵巢癌使用紫杉醇的资料。[结果]57例中31例可以评价疗效 ,总有效率32.3%(10/31) ,其中CR9.7 %(3/31) ,中位缓解期6个月 ;PR22.6 %(7/31) ,中位缓解期3.3个月。骨髓抑制29.8%(17/57) ,其中Ⅲ～Ⅳ度8.8%(5/57) ,面部潮红、胃肠道反应和肌肉疼痛的发生率分别为29.8%(17/57)、31.6%(18/57)和28.1%(16/57)。29例患者在化疗前采用简化的预用药方法 ,共84个疗程 ,无1例出现严重过敏反应。脑转移的发生率为8.8 %(5/57)。[结论]紫杉醇为主的化疗对难治性卵巢癌有一定疗效 ,其毒性反应可以忍受 ,简化的预用药方法值得进一步探讨。曾接受紫杉醇治疗的患者 ,发生脑转移的机率可能较高。

To investigate the efficacy,toxicity of paclitaxel-based chemotherapy in the treatment of refractory epithelial ovarian cancer (EOC)and the possibility of simplizing the pretreatment medication.The clinical data of 57 cases with EOC having received paclitaxel-based chemotherapy during Jul.1,1997 to Dec.31,2000 in our hospital were analyzed retrospectively.31 of 57 cases were eligible for response evaluation. The overall response rate was 32.3% (10/31),and CR 9.7%(3/31),PR 22.6%(7/31).The median response-relapse interval for CR patients was 6 months,and 3.3 month for PR patients.The myelosuppression rate was 29.8%(17/57),and 8.8%(5/57)for grade 3～4 hematological toxicity. The rate of facial flush,gastrointestinal reaction and myosalgia was 29.8%(17/57),31.6%(18/57)and 28.1%(16/57)respectively.Modified pretreatment method was used in 84 courses(29 cases)of paclitaxel-based chemotherapy.No severe hypersensitivity was observed.The brain metastatic rate in this group was 8.8%(5/57),higher than that of EOC patients reported in literatures who didn't received paclitaxel.[Conclusion]Paclitaxel-based chemotherapy is effective for refractory EOC and the toxicity is tolerable.The modified pretreatment method deserved to be further investigated.The brain metastatic rate in patients having received paclitaxel seemed to be higher than that of patients having not received paclitaxel.