复发性卵巢上皮癌“常规化疗药物疗效预测分子靶向化疗”的初步探讨

目的:探讨一种新的复发癌化疗策略—“常规化疗药物疗效预测分子靶向化疗”(pred ictive molecule targeted chemotherapy,PMTC),即根据肿瘤组织的常规化疗药物疗效预测分子的表达情况选择预测敏感的化疗药物,避开耐药的化疗药物。方法:对照组为2002年到2003年按经验用药治疗的复发性卵巢上皮癌16例,计算缓解率。实验组(PMTC组)为2004年开始前瞻性研究连续收治的9例复发性卵巢上皮癌患者,免疫组化检测肿瘤组织p53等6个疗效预测分子的表达,从而选择二线或三线化疗药物,计算缓解率。经χ2检验比较组间临床缓解率的差异。结果:对照组总的临床缓解率为26%,其中二线化疗缓解率为31%,三线化疗缓解率为14%。PMTC组的缓解率为78%(7/9),其中早期复发5例全部缓解。PMTC组缓解率显著高于对照组(P=0.011)。结论:PMTC是一种新的治疗复发性卵巢癌的有效选择。

The "predictive molecule targeted chemotherapy" for relapsed ovarian cancer-a pilot study

Objective: To explore a new treatment strategy—the"predictive molecule targeted chemotherapy,PMTC",e.g.to choose supposedly sensitive protocols and avoid supposedly resistant protocols based on the specific predictive molecule expression of individual tumor tissue.Methods:16 relapsed ovarian cancer patients were analysed restrospectively between Jan.2002 and Dec.2003,as the experience-directed chemotherapy group(control group),to calculate the response rate.9 relapsed ovarian cancer patients were recruited prospectively after Jan.2004,whose chemotherapy drug choice were based on the expression of 6 predictive molecules(p53,et al.)detected by means of immunohistochemistry,as the PMTC group,to calculate the response rate.Two rates were compared by means of χ~2 test.Results:The response rate of control group was 26%,including 31% for second line and 14% for third line respectively.The response rate of PMTC group was 78%,in which 5 cases of early relapse all responsed.The difference was significant(P=0.011).Conclusion:The PMTC is a new effective method to treat the relapsed ovarian cancer.