聚乙二醇化脂质体多柔比星联合异环磷酰胺治疗晚期转移性软组织肉瘤

发布时间：2018-03-23 20:21

本文选题：聚乙二醇化脂质体多柔比星　切入点：异环磷酰胺　出处：《中国癌症杂志》2017年09期

【摘要】：背景与目的:软组织肉瘤一旦出现远处转移,预后极差,中位生存时间不到1年。多柔比星联合异环磷酰胺(ifosfamide,IFO)(AI方案)是晚期软组织肉瘤常用的一线联合治疗方案。聚乙二醇脂质体多柔比星(pegylated liposomal doxorubicin,PLD)活性成分为盐酸多柔比星,药物包裹在脂质体中,可减少多柔比星的临床毒性反应。该研究探讨PLD联合IFO治疗晚期转移性软组织肉瘤的临床疗效和安全性。方法:选取晚期转移性软组织肉瘤患者25例,使用PLD联合IFO方案,PLD剂量30 mg/m~2,静脉滴注,第1天;IFO剂量1.8 g/m~2,静脉滴注,第1~5天;美司钠360 mg/m~2,用IFO时0、4和8 h,21 d为1个周期。结果:所有患者化疗1~8个周期,中位周期数4。25例患者中部分缓解9例(36%),疾病稳定12例(48%),疾病进展4例(16%),疾病控制率(完全缓解+部分缓解+疾病稳定)为84%(21/25)。中位无进展生存时间为7.3个月(95%CI:4.6~10.0个月)。由于失访病例较多,中位总生存时间未随访到。化疗后3/4级不良反应包括白细胞下降(20%)、粒细胞下降(28%)、贫血(4%)和呕吐(4%)。只有1例患者治疗过程中予以减量。结论:临床应用PLD联合IFO方案治疗晚期转移性软组织肉瘤疗效确切,且毒性反应较轻,值得进一步深入研究。
[Abstract]:Background & objective: the prognosis of soft tissue sarcoma with distant metastasis is very poor. The median survival time was less than one year. Doxorubicin combined with ifosfamide ifos-ifosfamide-ifos-ifos-ifos-ifos-ifosfamide-ifos-iOOPI-AI regimen is a common first-line combination therapy for advanced soft tissue sarcomas. The active component of pegylated liposomal doxorubicinine (PLD) is doxorubinine hydrochloride (doxorubinine hydrochloride). Drug encapsulation in liposomes can reduce the clinical toxicity of doxorubicin. This study was designed to investigate the clinical efficacy and safety of PLD combined with IFO in the treatment of advanced metastatic soft tissue sarcoma. Methods: 25 patients with advanced metastatic soft tissue sarcoma were selected. The dosage of PLD combined with IFO regimen was 30 mg / m ~ 2, intravenous infusion, 1. 8 g / m ~ (-2) intravenously on day 1, intravenous drip for 1 ~ 5 days, and Meisna 360 mg / m ~ (2) for one cycle at 0 ~ 4 and 8 h / 21 days after IFO. Results: all patients received 1 ~ 8 cycles of chemotherapy. The median period of 4.25 cases included partial remission in 9 cases, partial remission in 9 cases, stable disease in 12 cases, disease progression in 4 cases and disease progression in 4 cases. The disease control rate (complete remission partial remission disease stability) was 84 / 21 / 25. The median survival time without progression was 7.3 months, 95 CIW 4.6- 10.0 months. As there are more cases of missing visits, The median total survival time was not followed up. Adverse reactions of grade 3 / 4 after chemotherapy included leukocytopenia 20, granulocytopenia 28, anemia 4) and vomiting 4. Only 1 patient was treated with reduced dose. Conclusion: PLD combined with IFO is used clinically. The treatment of advanced metastatic soft tissue sarcoma is effective. And the toxicity reaction is relatively light, which is worthy of further study.
【作者单位】：复旦大学附属肿瘤医院肿瘤内科;复旦大学上海医学院肿瘤学系;
【分类号】：R738.6

【相似文献】