盐酸托泊替康治疗复发性晚期卵巢癌18例临床分析

Single Topotecan or in combination with other chemotherapeutic agents for 18 recurrent advanced ovarian cancer patients

目的 观察托泊替康 (Topotecan)单药及联合用药对复发卵巢癌患者的疗效和毒性。方法 18例晚期上皮性卵巢癌患者分为 3组 :(1)单药组 :Topotecan 1.2mg/m2 ,静脉滴注 ,连续 5d ,30min内 ,每 2 1d重复 ;6例次 ,14个疗程。 (2 )双药组 :Topotecan 0 .7mg/m2 静脉滴注 ,连续 5d ,30min内 ;顺铂 2 0mg/m2 第 2 ,3 ,4天 ,每 2 8d重复 ;共 4例次 ,7个疗程。 (3)三药联合组 :Topotecan 0 .7mg/m2静脉滴注 ,连续 4d ;紫杉醇 10 0mg/m2 第 1天静脉滴注 ,3h ;顺铂 2 0mg/m2 静脉滴注 ,第 2 ,3 ,4天 ,每2 8d重复 ;共 12例次 ,2 7个疗程。全组共 18个疗程 ,平均 2 .7个疗程。结果 18例中 ,部分缓解 3例(单药治疗 1例 ;三药联合 2例 ,其中 1例为单药失败后改三药联合 ) ,稳定 5例 ,进展 10例 ,有效率 16 .7%。主要不良反应为Ⅲ～Ⅳ度白细胞减少 10例 (5 5 .6 % ) ,发生在 16个 (33 .3% )疗程 ;Ⅲ～Ⅳ度血小板减少 6例 (33.3% ) ,发生在 8个 (16 .7% )疗程 ;Ⅲ度红细胞减少 6例 (33.3 % ) ,发生在 8个 (16 .7% )疗程上。结论 Topotecan系晚期卵巢癌经铂类及紫杉醇类药物治疗失败后的有效药物。单药Topotecan治疗失败后 ,可试用三药联合。

Objective This study was designed to evaluate the efficacy and toxicity of topotecan hydrochloride, used singly or combined with other drugs in patients with recurrent advanced ovarian cancer. Methods Eighteen ovarian cancer patients who had received cytoreductive operation 1 to 3 times and 8 to 18 courses of chemotherapy but still failed in DDP based(86.3%) and Taxol based(32.7%) as well as combined DDP and Taxol based(30.7%) chemotherapy, were divided into 3 groups: 1. Topotecan 1.2 mg/m 2 q.d.i.v. for 5 consecutive days every 3 weeks for a total of 6 patients and 14 courses. 2. Topotecan 0.7 mg/m 2 q.d.i.v. for 5 consecutive days and cis platin 20 mg/m 2 q.d.i.v. for 3 consecutive days over 4 weeks and 3. Topotecan 0.7 mg/m 2 q.d.i.v. for 4 consecutive days and taxol 100 mg/m 2 q.d.i.v. for one day as well as cis platin 20 mg/m 2 q.d.i.v. for 3 consecutive days totalling 12 patients and 27 courses. All together 18 courses, median 2.7 courses, were given. Results All 18 patients were evaluable. PR was achieved in 3 patients with a response rate of 16.7%. The main adverse effects were hematological toxicity, lasting for 3 27 days. Ten (55.6%) patients developed leucocytopenia Grade Ⅲ Ⅳ which occurred in 16(33.3%) courses. Six(33.3%) patients developed thrombocytopenia Grade Ⅲ Ⅳ which occurred in 8(16.7%) courses. Six(33.3%) patients developed RBC reduction Grade Ⅲ which occurred in 8(16.7%) courses. Peripheral nerve inflammation was most serious in the non hematlolgic toxicity.Conclusion Topotecan is effective in recurrent advanced ovarian cancer patients who have failed in DDP or/and taxol based regimes. Topotecan combined with cisplatin and taxol would be effective even if single topotecan has failed. Careful evaluation before treatment is indicated. [