含多西他赛方案作为骨肉瘤二线化疗的疗效观察

Clinical observation of docetaxel based regimens as the second-line chemotherapy in osteosarcoma

目的探讨含多西他赛方案二线治疗一线化疗失败的骨肉瘤肺转移患者的有效性和安全性。方法收集2012年1月至2013年12月间我科收治的11例一线化疗失败的骨肉瘤肺转移患者,给予多西他赛（75 mg/m2,d8）联合吉西他滨（675 mg/m2,d1、d8）/洛铂（30 mg/m2,d2）方案二线化疗,21天为1周期,共化疗6个周期。采用RECIST标准1.0版评价疗效,NCI-CTC标准3.0版观察不良反应。结果 11例患者均完成化疗,可评价疗效。无完全缓解（CR）病例,部分缓解（PR）1例,疾病稳定（SD）4例,疾病进展（PD）6例;有效率（RR）为9.1%,疾病控制率（DCR）为45.5%。随访6~23个月,3例死亡。中位无进展生存时间为10.5个月,中位生存时间为18.0个月,1年生存率为83.3%。主要不良反应为限制性骨髓抑制,化疗期间患者无明显肾功能异常及过敏反应,仅出现4级中性粒细胞及血小板减少1例。结论含多西他赛方案二线治疗骨肉瘤肺转移,近期疗效满意,毒副反应可以耐受。

Objective To investigate the efficacy and side effects of docetaxel based regimens as the second-line chemothera-py in osteosarcoma with lung metastasis.Methods From January 2012 to December 2013, 11 osteosarcoma patients with lung metasta-sis whom failed from first-line chemotherapy were taken docetaxel（75 mg/ m2, d8） combined with gemcitabine（675 mg/ m2, d1, d8） /platinum（30 mg/ m2, d2） as the second-line chemotherapy. 21 days was a cycle. The first-line chemotherapy contained cisplatin, ifos-famide, adriamycin methotrexate alternating scheme. The efficacy was evaluated by RECIST 1. 0 criterion, and side effects were recor-ded by NCI-CTC 3. 0 criterion.Results All patients finished treatment, and could be evaluated. There was no complete remission（CR） case, partial remission（PR） in 1 case, stable disease（SD） in 4 cases, progression of disease（PD） in 6 cases; and the re-sponse rate（RR） was 9. 1%, disease control rate（DCR） was 45. 5%. During the follow-up period, 3 patients died. The median pro-gression free survival time was 10. 5 months, the median overall survival time was 18. 0 months, and 1-year survival rate was 83. 3%.The major adverse reactions were limiting myelosuppression during chemotherapy. There was no patients with renal dysfunction and al-lergic reaction, grade 4 neutropenia and thrombocytopenia was occured in 1 case.Conclusion Docetaxel based regimen is effective asthe second-line chemotherapy in osteosarcoma with lung metastasis, and the short-term curative effect is satisfactory, toxicity can betolerated.