白蛋白结合型紫杉醇联合铂类或异环磷酰胺治疗复发性卵巢癌的疗效及安全性分析

发布时间：2018-04-29 04:24

本文选题：白蛋白结合型紫杉醇 + 卵巢癌　；参考：《现代妇产科进展》2017年05期

【摘要】：目的:观察白蛋白结合型紫杉醇联合铂类或异环磷酰胺治疗复发性卵巢癌的临床疗效及毒副反应。方法:回顾分析我院46例复发性卵巢癌患者接受含不同制剂紫杉醇的联合化疗的疗效及安全性。26例铂敏感复发患者分别采用白蛋白结合型紫杉醇或溶剂型紫杉醇联合铂类化疗,20例铂耐药复发患者采用白蛋白结合型紫杉醇或溶剂型紫杉醇联合异环磷酰胺方案,每21天为1疗程,直至完全缓解后再巩固2个疗程或疾病进展或出现不可耐受的不良反应。比较患者间临床效果、毒副作用及预后差异。结果:铂敏感复发患者中,白蛋白结合型紫杉醇组的完全缓解率显著高于溶剂型紫杉醇组(60%vs 18.8%,P0.05);两组的客观缓解率分别为90%、75%。铂耐药复发患者中,白蛋白结合型紫杉醇组的完全缓解率显著高于溶剂型紫杉醇组(16.7%vs 0%,P0.05);两组的客观缓解率分别为66.7%、57.1%。铂敏感复发患者中,白蛋白结合型紫杉醇组及溶剂型紫杉醇组的中位无进展生存时间(PFS)分别为10.25、7.5个月(P0.05);铂耐药复发患者中白蛋白结合型紫杉醇组及溶剂型紫杉醇组的中位PFS分别为7.8、5.6个月(P0.05)。4组患者的不良反应主要表现为骨髓抑制和胃肠道反应,铂敏感、铂耐药患者中白蛋白结合型紫杉醇组及溶剂型紫杉醇组各种严重不良反应的发生率均无显著差异。结论:与溶剂型紫杉醇比较,含有白蛋白结合型紫杉醇的联合化疗方案治疗铂敏感或铂耐药复发性卵巢癌均有更高的完全缓解率,可有效延长PFS,且不额外增加严重毒副反应的发生率。
[Abstract]:Aim: to observe the clinical efficacy and side effects of albumin bound paclitaxel combined with platinum or isocyclophosphamide in the treatment of recurrent ovarian cancer. Methods: the efficacy and safety of 46 patients with recurrent ovarian cancer receiving paclitaxel containing different agents were retrospectively analyzed. 26 patients with platinum sensitive recurrence were treated with albumin binding paclitaxel or solvent paclitaxel respectively. Twenty patients with recurrent platinum resistance were treated with albumin bound paclitaxel or solvent paclitaxel combined with isocyclophosphamide. Every 21 days is a course of treatment, until complete remission after consolidation of 2 courses or progress of the disease or the emergence of an intolerable adverse reaction. The clinical effects, side effects and prognosis of the patients were compared. Results: the complete remission rate of albumin bound paclitaxel group was significantly higher than that of solvent type paclitaxel group (60 vs 18.8 P 0.05), and the objective remission rate of both groups was 90%. In patients with recurrent platinum resistance, the complete remission rate in albumin bound paclitaxel group was significantly higher than that in solvent taxol group, and the objective remission rate in both groups was 66.7% and 57.1%, respectively. In patients with recurrent platinum sensitivity, The median progressive survival time (PFS) of albumin bound paclitaxel group and solvent taxol group were 10.25 and 7.5 months, respectively, while the median PFS of albumin bound paclitaxel group and solvent taxol group were 7.8 ~ 5.6, respectively. The main adverse reactions in P0.054-group were myelosuppression and gastrointestinal reaction. There was no significant difference in the incidence of severe adverse reactions between albumin bound paclitaxel group and solvent paclitaxel group. Conclusion: compared with solvent-based paclitaxel, combination chemotherapy with albumin binding paclitaxel has a higher complete remission rate in the treatment of platinum-sensitive or platinum-resistant recurrent ovarian cancer. PFS can be effectively prolonged without any additional increase in the incidence of severe side effects.
【作者单位】：上海交通大学医学院附属仁济医院妇产科;
【基金】：国家自然基金面上项目(No:81472843) 上海市科学技术委员会上海市科研计划项目(No:14ZR1424700)
【分类号】：R737.31

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