IAP方案治疗复发及耐药性卵巢上皮性癌的临床分析

目的 探讨奥沙利铂+表柔比星+异环磷酰胺(1AP)方案治疗复发及耐药性卵巢上皮性癌(卵巢癌)的有效性和安全性.方法 2004年7月-2008年1月间,北京大学人民医院共收治复发及耐药性卵巢癌患者25例,均行IAP方案(其中奥沙利铂130 mg/m2,表柔比星50～60 mg/m2,异环磷酰胺3～4 g/m2)化疗,疗程间隔3周.其中接受≥2个疗程IAP方案化疗的21例纳入本研究,并对其疗效及化疗副反应进行回顾性分析.21例患者共接受80个疗程的IAP方案化疗,化疗疗程的中位数为4个[(2～7)个].结果 (1)疗效评价:21例患者中,完全缓解10例(48%),部分缓解5例(24%),病情稳定1例(5%),病情进展5例(24%),有效率达71%.其中,原发性铂类药物耐药患者的有效率为60%(6/10),继发性铂类药物耐药患者的有效率为7/8.IAP方案化疗后肿瘤无进展时间的中位数为11个月(1～33个月),总生存时间的中位数为31个月(1～71个月).(2)副反应:80个疗程的化疗中,血液学副反应(Ⅲ～Ⅳ度)的发生率为30%(24/80),非血液学副反应包括周围神经毒性反应(38%,30/80)、浅表静脉炎(29%,23/80)等.结论 IAP方案用于复发及耐药性卵巢癌患者的三、四线挽救性化疗,其疗效较好,且副反应可耐受,但有待扩大样本进一步验证.

Efficacy and tolerability of the combination of oxaliplatin, ifosfamide, and epirubicin in treatment of recurrent or platinum-resistant ovarian epithelial cancer patients

Objective To evaluate the efficacy and tolerability of the combination of oxaliplatin,ifosfamide and epirubicin(IAP)in treatment of recurrent or platinum-resistant ovarian cancer patients.Methods A total of 25 patients received the combined chemotherapy of ifosfamide(3-4 g/m2),epirubicin(50-60 mg/m2)and oxaliplatin(130 mg/m2).The cycles were repeated every 21 days.The efficacy and toxicity were evaluated in 21 patients who received more than 2 cycles of IAP chemotherapy.Results The overall response rate was 71%,with a complete response in 10(48%),partial response in 5(24%),stable disease in one(5%),and disease progression in 5(24%).The median progression-free and overall survival time were 11(1 to 33)months and 31(1 to 71)months.While overall response rate was 60%in 10 patients with primary platinum resistant,and 88%in 8 patients with secondary platinumresistant.Grade Ⅲ-Ⅳ myelosuppression rate wss 30%.The most common non-hematologic toxicity was perineurotoxicity(38%).Conclusions The combination of oxaliplatin,ifasfamide and epirubicin appears to be effective for recurrent or platinum-resistant ovarian cancer patients as salvage chemotherapy and the toxicity is also tolerable.However,it needs to be evaluated by multiple clinical trials.