紫杉醇与环磷酰胺分别联合铂类药治疗卵巢癌的对比研究

Comparison of paclitaxel containing platinum and cyclophosphamide containing platinum chemotherapy in women with advanced epithelial ovarian cancer

目的 :比较紫杉醇联合铂类药物 (TP方案 )与环磷酰胺加铂类药物 (CP方案 )治疗Ⅲ、Ⅳ期卵巢上皮癌的疗效。方法 :化疗方案每一疗程采用 2d疗法 ,每种药物d 1或d 2给药 ,采用大剂量单次给药。对 2 4例Ⅲ、Ⅳ期卵巢上皮癌给予TP方案化疗 :紫杉醇剂量为 135mg·m-2 ,溶于 5 %GS 5 0 0ml中 ,静滴 ,3h ,d 1;顺铂 (DDP) 75mg·m-2 ,d 2 (或卡铂按AUC =5计算所得的剂量 ) ,前 3～ 4个疗程采用腹腔给药 ,以后均静脉给药。 30例对照组病人采用环磷酰胺加铂类药为主的CP方案。环磷酰胺 (CTX )6 0 0mg·m-2 ,静注 ,d 1;阿霉素 (ADM ) 4 0～6 0mg·m-2 ,静注 ,d 1;长春新碱 (VCR) 2mg ,静注 ,d 1;DDP 6 0～ 80mg·m-2 (或卡铂 ,剂量按AUC =5计算 )。铂类药物用药时间、途径及水化均与TP方案相同。结果 :TP方案化疗组CR为 8例 ,PR为 10例 ,总有效率为 75 % ;CP方案对照组CR 4例 ,PR 8例 ,总有效率为 4 0 % ,TP方案化疗组有效率显著高于CP方案化疗组 (P <0 .0 5 )。TP治疗组中位生存期为 4 1.5个月 ,高于CP对照组的 32 .6个月 (P <0 .0 1)。结论 :TP方案治疗Ⅲ、Ⅳ期卵巢上皮癌疗效显著优于CP方案。

AIM : To compare the therapeutic effect of paclitaxel containing platinum (cisplatin or carboplatin) and cyclophosphamide containing platinum chemotherapy in women with epithelial ovarian cancer. METHODS : 24 cases with advanced epithelial ovarian cancer after initial surgery received paclitaxel and cisplatin or carboplati. Paclitaxel ( 135 mg·m -2, over a period of 3 hours) was administered iv once every 3 to 4 weeks, in comparison with those 30 cases treated with 'CAP 'or 'CVP' regimen. RESULTS : The overall median survival time was significantly longer in the paclitaxel-platinum group than that in the cisplatin-cyclophosphamide group (median 41.5 vs 32.6 mon, P < 0.01). Among 24 women with measurable disease, 75 percents in the 'TP' group responded to the therapy, comparing with 40 percent in the 'CP' group ( P <0.05). CONCLUSION : Paclitaxel and platinum agent is more effective than 'CP' regimen in the treatment of patients with advanced epithelial ovarian cancer.