成人脂肪肉瘤临床化疗疗效分析

Clinical efficacy of chemotherapy in the treatment of adult liposarcoma

目的探讨晚期或复发脂肪肉瘤患者化疗有效率及临床预后的相关因素。方法选取2014年7月至2019年5月间中国医学科学院北京协和医学院肿瘤医院收治的20例局部复发或晚期脂肪肉瘤患者,回顾性分析表柔比星联合异环磷酰胺方案化疗的有效率及其安全性。结果20例患者中,完全缓解0例,部分缓解4例(20.0%),稳定9例(45.0%),进展7例(35.0%),疾病控制率为65.0%(13/20)。中位无进展生存时间(PFS)为8.9个月(95%CI 1.4~13.8个月),中位总生存时间为16.1个月(95%CI 9.5~21.4个月)。主要不良反应包括恶心和呕吐,均为1~2级,骨髓抑制1~3级18例(90.0%),4级2例(10.0%)。COX多因素回归分析显示,性别和入院状态是影响PFS的独立相关因素,差异有统计学意义(P<0.05)。结论表柔比星联合异环磷酰胺方案治疗晚期或复发脂肪肉瘤疗效肯定,不良反应可控,患者的性别和一般状态可能是影响预后的独立相关因素。

Objective To analyze the efficacy rate of chemotherapy and factors influencing clinical prognosis in patients with advanced or recurrent liposarcoma.Methods Twenty patients with locally recurrent or advanced liposarcoma treated at Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical Collegefrom between July 2014 and May 2019 were selected.The efficacy and safety of epirubicin combined with ifosfamide regime were analyzed retrospectively.Results Among the 20 patients,complete remission(CR)was achieved in none,partial remission in 4 patients(20.0%),stable disease(SD)in 9 patients(45.0%)and progressive disease(PD)in 7 patients(35.0%).Disease control rate(DCR)was 65%.The median progression-free survival time(PFS)was 8.9 months(95%CI 1.4 to 13.8 months),and the median overall survival time(OS)was 16.1 months(95%CI 9.5 to 21.4 months).The main adverse reactions included nausea and vomiting,all of which were grade 1 to 2 and grade 1 to 3 myelosuppression in 18 patients(90.0%)and grade 4 myelosuppression in 2 patients(10.0%).Cox multivariate regression analysis showed that gender and admission status were independent factors influencing PFS.Conclusion Epirubicin combined with ifosfamide is effective in the treatment of advanced or recurrent liposarcoma,and the adverse reactions can be controlled.Gender and general status may be independent factors influencing the prognosis.