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适形放疗联合托泊替康化疗治疗铂类耐药的复发卵巢癌临床观察
引用本文:魏萍,盛修贵,山长平,韩晓运. 适形放疗联合托泊替康化疗治疗铂类耐药的复发卵巢癌临床观察[J]. 中国肿瘤临床, 2013, 40(13): 779-783. DOI: 10.3969/j.issn.1000-8179.2013.13.008
作者姓名:魏萍  盛修贵  山长平  韩晓运
作者单位:①.山东省肿瘤医院妇瘤科(济南市250117)
摘    要:   目的   观察三维适形放疗联合托泊替康化疗治疗铂类耐药复发卵巢上皮癌的疗效及不良反应。   方法   回顾性分析2008年6月至2011年6月山东省肿瘤医院收治的铂类耐药复发卵巢上皮癌患者42例,其中三维适形放疗联合托泊替康化疗22例(放化疗组),单药托泊替康化疗20例(单纯化疗组)。放化疗组以15MV X线行三维适形照射,1.8~2.0 Gy/次/d,5次/周,总剂量45~65Gy,平均中位剂量为52.5 Gy。于放疗开始后第1周行托泊替康化疗2.0 mg/m2,第1、8、15天给药,每28天重复。单纯化疗组于第1周开始行托泊替康化疗4.0 mg/m2,第1、8、15天给药,每28天重复。   结果   放化疗组、单纯化疗组中位随访时间分别为18.5(2~37.7)个月、10.8(1.5~29.6)个月;总缓解率分别为42.1%(8/19)、11.1%(2/18);临床获益率分别为68.4%(13/19)、22.2%(4/18),两组比较有显著性差异(P < 0.05)。中位疾病无进展期分别为9.8、6.6个月,两组比较有显著性差异(P < 0.001)。中位生存期分别为19.7、12.5个月,两组比较有显著性差异(P < 0.05)。Ⅲ度消化道反应发生率分别为26.3%(5/19)、16.7%(3/18);Ⅲ~Ⅳ级血液学毒性发生率分别为21.1%(4/19)、22.2%(4/18),两组比较无显著性差异(P>0.05)。   结论   三维适形放疗联合托泊替康化疗对铂类耐药复发卵巢上皮癌有较好的疗效,且不良反应轻微,可作为复发患者的补救治疗措施。 

关 键 词:复发卵巢上皮癌   铂类耐药   三维适形放疗   托泊替康   疗效
收稿时间:2012-08-02

Clinical observation of conformal radiotherapy with topotecan che-motherapy on patients with platinum-resistant recurrent ovarian cancer
Ping WEI , Xiugui SHENG , Changping SHAN , Xiaoyun HAN. Clinical observation of conformal radiotherapy with topotecan che-motherapy on patients with platinum-resistant recurrent ovarian cancer[J]. Chinese Journal of Clinical Oncology, 2013, 40(13): 779-783. DOI: 10.3969/j.issn.1000-8179.2013.13.008
Authors:Ping WEI    Xiugui SHENG    Changping SHAN    Xiaoyun HAN
Affiliation:①.Department of Gynecologic Oncology, Shandong Tumor Hospital, Jinan 250117②.Department of Oncology, the Affiliated Hospital of Jining Medical College, Jining 272100, China
Abstract:   Objective   This study aims to observe the efficacy and toxicity of three-dimensional conformal radiotherapy (3DCRT) combined with weekly topotecan hydrochloride (Top-Hyd) chemotherapy on patients with platinum-resistant recurrent ovarian cancer.   Methods   Medical data of 42 patients with platinum-resistant recurrent ovarian cancer between June 2008 and June 2011 were retrospectively reviewed. OAOf these 42 patients, 22 underwent 3DCRT combined with weekly Top–Hyd chemotherapy, whereas the remaining 20 underwent simple chemotherapy (SCT). Doses from 45 Gy to 65 Gy were planned to deliver fractions ranging from 1.8 Gy to 2 Gy to patient abdomen and pelvis. Top–Hyd (4 mg/m2) was aintravenously administered 1, 8, and 15 days from radiotherapy, with a cycle of 28 days.   Results   By December 31, 2011, the median follow-up time for the 3DRT group was 18.5 months, whereas that for the SCT group was 10.8 months. The total response rate and the clinical beneficial rate were significantly higher in the 3DCRT group than in the SCT group (total response rate, 42.1% vs. 11.1%; clinical beneficial rate, 68.4% vs 22.2% at P < 0.05). The median of progression-free survival time was 9.8 months for the 3DCRT group and 6.6 months for the SCT group. The median total survival time was 19.7 months in the 3DCRT group, and 12.5 months in the SCT group. Significant differences between the 2 groups were indicated (P < 0.001). No significant difference in overall toxicity was indicated between the two groups (P>0.05).   Conclusion   The combined 3DCRT treatment and Top-Hyd chemotherapy results in enhanced response and tolerable toxicity compared with SCT in patients with recurrent ovarian cancer infiltrating the pelvic and retroperitoneal lymph node metastasis. So, it may be the salvage regimen for recurrent ovarian cancer and provide a new therapeutic option for the consolidation treatment of advanced ovarian carcinoma. 
Keywords:recurrent epithelial ovarian cancer  platinum resistance  conformal radiotherapy  topotecan,efficacy
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