羟基喜树碱治疗卵巢癌腹水的近期疗效观察

A Clinical Study of Hydroxycamptothecin in the Treatment of Ovarian Carcinomas with Peritoneal Effusion

目的 :评价羟基喜树碱 (hydroxycamptothecin ,HCPT)对卵巢癌腹水的治疗价值。方法 :HCPT治疗组Ⅱ、Ⅲ期卵巢癌合并腹水患者 16例 ,均为顺铂治疗失败或不能耐受顺铂治疗的患者 ,腹穿尽量抽尽腹水或置管引流 ,注入HCPT 10～ 2 0mg +NS 2 0mL ,每周 2～ 3次 ,连用 2～ 4周 ,全身CAH方案化疗4～ 12个疗程 ;顺铂 (DDP)治疗组 (对照组 )卵巢癌合并腹水患者 2 8例 ,腹穿抽液后注入DDP 4 0～ 60mg+NS 50mL ,水化利尿 ,每周 1～ 2次 ,连用 4周 ,全身CAP方案化疗 3～ 12个疗程。结果 :HCPT治疗组患者CR 8例 ,PR 5例 ,有效率 (CR +PR) 81.3% ( 13/ 16) ;对照组有效率 64.3% ( 18/ 2 8) ,两组疗效相似 (P >0 .75)。HCPT组白细胞降低Ⅱ度以上 2 / 16,较对照组显著降低 ( 2 0 / 2 8,0 .0 2 5>P >0 .0 1) ;HCPT组 16/ 16的患者消化道反应在 0～Ⅰ度 ,对照组Ⅱ～Ⅳ度消化道反应病例 2 0 / 2 8,两组比较差异有显著性 (P <0 .0 0 5) ;脱发反应两组差异无显著性 (P >0 .2 5)。结论 :HCPT腹腔灌注结合全身化疗治疗卵巢癌腹水疗效可靠 ,毒副反应小 ,尤适合老年及一般情况较差患者的治疗。

Objective To evaluate the result of hydroxycamptothecin (HCPT) for the peritoneal effusion.Methods Sixteen cases of ovarian carcinomas with peritoneal effusion were treated with concurrent peritoneal infusion of HCPT 10-20 mg,2-3 times perweek for 2-4 weeks,and iv infusion of CAH regimen for 4-12 cycles,Total dose of HCPT was 90-160 mg.Twenty eight cases of ovarian carcinomas in control group were treated with concurrent peritoneal infusion of cisplatin 40-60 mg,1-2 times perweek for 4 weeks,and iv infusion of CAP regimen for 3-12 cycles.Results The response rates in HCPT group (13/16,81.3%) and in DDP control group (18/28,64.3%) were not different( x =0.100 2, P >0.75).The incidences of serious leukopenia(>Ⅱ o,2/16) and serious nausea and vomiting(Ⅱ-Ⅳ 0,0/16) in HCPT group were lower than that in control group (20/28,and 20/28,0.025> P >0.001 and P <0.005).Conclusions The treatment of ovarian carcinomas with peritoneal effusion with concurrent peritoneal infusion of hydroxycamptothecin and iv infusion of CAH project is effective and safe,and is especially suitable for old and weakening patients.