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山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (5): 122-124.

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培美曲塞单药或联合奈达铂治疗对卡铂及紫杉醇耐药的复发晚期上皮性卵巢癌

康马飞,卜庆,刘瑛,骆梅青,廖漓漓,涂江江   

  1. 桂林医学院附属医院肿瘤内科, 广西 桂林  541001
  • 收稿日期:2010-11-13 出版日期:2011-05-10 发布日期:2011-05-10
  • 作者简介:康马飞(1964- ),男,主要从事肿瘤的临床治疗研究。E-mail:kmfgl@163.com

Pemetrexed alone or in combination with nedaplatin in recurrence and carboplatin/paclitaxel resistance advanced epithelial ovarian carcinoma

KANG Ma-fei,  BU Qing,  LIU Ying,  LUO Mei-qing, LIAO Li-li,  TU Jiang-jiang   

  1. Department of Medical Oncology,  Affiliated Hospital of Guilin Medical College,  Guilin 541001, Guangxi,   China
  • Received:2010-11-13 Online:2011-05-10 Published:2011-05-10

摘要:

目的     观察培美曲塞单药或联合奈达铂治疗对卡铂及紫杉醇耐药的复发晚期上皮性卵巢癌的疗效和不良反应。方法     将对卡铂及紫杉醇耐药的复发晚期上皮性卵巢癌50例随机分为A、B两组,A组第1天给予培美曲塞500mg/m2,每21天重复; B组第1天给予培美曲塞500mg/m2、奈达铂80mg/m2,每21天重复;直到疾病恶化为止。结果     两组均无完全缓解病例,部分缓解A组4例、B组11例,稳定A组15例、B组11例,病情恶化A组6例、B组3例,总有效率A组16.0%、B组44.0%,差异有统计学意义(χ2=4.667,P=0.031)。中位肿瘤恶化时间A组2.4个月,B组3.6个月(P=0.046)。中位生存期A组6.0个月,B组7.5个月(Logrank,P=0.048)。不良反应主要是骨髓抑制。结论    培美曲塞单药或联合奈达铂治疗对卡铂及紫杉醇耐药的复发晚期上皮性卵巢癌均有效,培美曲塞联合奈达铂总有效率、中位肿瘤恶化时间及中位生存期均明显好于培美曲塞单药,骨髓抑制较明显,但可以耐受。

关键词:  卵巢肿瘤;药物疗法;培美曲塞;奈达铂;治疗结果

Abstract:

Objective    To observe the efficacy and side effect of pemetrexed(PEM) alone or in combination with nedaplatin(NDP) in recurrence and carboplatin(CBP) and paclitaxel(PTX) resistance advanced epithelial ovarian carcinoma. Methods    Fifty patients with recurrence and CBP and PTX resistance advanced epithelial ovarian carcinoma were randomly divided into groups A and B. Twenty-five patients in group A were treated only with PEM 500mg/m2 on day 1 which was repeated every 21 days,  and twenty-five patients in group B were treated with PEM 500mg/m2,and NDP 80g/m2 on day 1 which was repeated every 21 days,  until disease had progressed. ResultsNo patients achieved  complete response (CR) in either group but 4 patients in group A(or 11 patients in group B) achieved a partial response (PR) and 15 patients in group A(or 11 patients in group B) achieved a stable disease (SD) and the overall response rate(ORR) was 16.0% in group A and 44.0% in group B(χ2=4.667,P=0.031). The median time to progression(mTTP) was respectively 2.4  months in group A and 3.6 months in group B(P=0.046) and the median survival (mS) was 6.0 months in group A and 7.5 months in group B(Log-rank,P=0.048). The major adverse effect was marrow depression. Conclusions    PEM alone or in combination with NDP were effective for recurrence and CBP/PTX resistance in advanced epithelial ovarian carcinoma. The ORR,  mTTP and mS of PEM in combination with NDP was significantly better than PEM alone and marrow depression was marked,  but tolerated. 

Key words: Ovarian neoplasms; Medical treatment; Pemetrexed; Nedaplatin; Treatment outcome

中图分类号: 

  • R737.31
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