紫杉醇联合顺铂不同给药途径治疗晚期卵巢癌的疗效观察

目的研究经腹腔灌注和静脉滴注两种途径应用紫杉醇联合顺铂治疗晚期卵巢癌的疗效和毒性反应。方法选择80例晚期卵巢癌患者随机分为紫杉醇联合顺铂静脉注射组(IV组)和紫杉醇联合顺铂腹腔灌注组(IP组)进行化疗。IV组给予紫杉醇135mg.m-2静脉滴注,24h后继以顺铂75mg.m-2静脉滴注。IP组予紫杉醇135mg.m-2静脉滴注,24h后继以顺铂100mg.m-2腹腔灌注,第8天予紫杉醇60mg.m-2腹腔灌注。每3周为1个疗程,完成6个疗程后观察疗效及毒副反应。结果 IP组在有效率、疾病控制率、无疾病进展生存期、中位生存期及2年生存率等方面均优于IV组(P<0.05)。不良反应主要有骨髓抑制、胃肠道反应、肝功能损害、神经毒性、关节肌肉痛和心功能异常等,以IP组发生率较高(P<0.05)。结论 IP组较IV组治疗晚期卵巢癌具有更好的疗效,但IP组毒副反应高于IV组,但可耐受。紫杉醇联合顺铂腹腔灌注化疗方案可作为晚期卵巢癌较为理想的化疗方法之一。

Efficacy of Paclitaxel plus Cisplatin in the Treatment of Advanced Ovarian Cancer by Different Administration Routes

Objective To study the clinical efficacy and toxicity of paclitaxel plus cisplatin in the treatment of advanced ovarian cancer by peritoneal perfusion or intravenous injection.Method 80 patients with advanced ovarian cancer were randomly divided into two groups:intravenous chemotherapy group(IV group) and intraperitoneal chemotherapy group(IP group).Patients in IV group were treated with Paclitaxel plus cisplatin as follows:paclitaxel 135 mg·m-2,i.v.,on 1?d,cisplatin 75 mg·m-2 with intravenous injection on 2?d,21?d as one cycle.Patients in IP group were treated with Paclitaxel plus cisplatin as follows:paclitaxel 135 mg·m-2,i.v.,on 1?d,cisplatin 100 mg·m-2 by intraperitoneal infusion on 2?d,and paclitaxel 60 mg·m-2 by intraperitoneal infusion on 8?d,21?d as one cycle.Clinical efficacies and toxicity of two groups were evaluated after 6 cycles.Results Effective rate,disease control rate,2 years’ survival rate and median progression-free survival time of the IP group were superior to that of IV group(P<0.05).The major toxic effects were myelosuppression,gastrointerstinal tract reactions,neurotoxicity,hypohepatia,muscle and joint pain,cardiac anomalies and so on.The incidence of these toxic effects in the IP group was higher than IV group(P<0.05).Conclusion Clinical efficacy of the IP group was better than that of the IV group in the treatment of advanced ovarian cancer.However incidence of toxicity in the IP group was also higher than IV group.But the adverse reactions caused by toxic medium can be tolerated.Intraperitoneal infusion with paclitaxel plus cisplatin is a more desired chemotherapy way in the treatment of advanced ovarian cancer.