国际肿瘤学杂志

国际肿瘤学杂志 ›› 2019, Vol. 46 ›› Issue (1): 32-35.doi: 10.3760/cma.j.issn.1673-422X.2019.01.007

• 论著 • 上一篇    下一篇

脂质体多柔比星单药与吉西他滨联合奥沙利铂对复发性铂耐药卵巢癌患者的疗效及安全性比较

褚超男1,黄琪2   

  1. 1湖南省肿瘤医院 中南大学湘雅医学院附属肿瘤医院妇瘤四科，长沙410006； 2湖南省人民医院 湖南师范大学附属第一医院药学二部，长沙410002
  • 收稿日期:2018-01-22 出版日期:2019-01-08 发布日期:2019-04-03
  • 通讯作者: 黄琪 E-mail:q12600073@163.com

Comparison of the efficacy and safety of liposome doxorubicin and gemcitabine combined with oxaliplatin in the treatment of recurrent platinum resistant ovarian cancer

Chu Chaonan1, Huang Qi2   

  1. 1Fourth Department of Gynecologic Tumor, Hunan Cancer Hospital & Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410006, China; 2Second Department of Pharmacy, Hunan People′s  Hospital & First Affiliated Hospital of Hunan Normal University, Changsha 410002, China
  • Received:2018-01-22 Online:2019-01-08 Published:2019-04-03
  • Contact: Huang Qi E-mail:q12600073@163.com

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摘要： 目的 评价和对比多柔比星单药治疗及吉西他滨联合奥沙利铂治疗两种二线化疗方案在复发性铂耐药卵巢癌患者化疗中的疗效与安全性。方法 收集2015年1月1日至2016年12月31日湖南省肿瘤医院收治的80例确诊为复发性铂耐药型卵巢癌患者，采用随机数字表法将患者分为单用脂质体多柔比星治疗组（PLD组）和采用吉西他滨联合奥沙利铂治疗组（G/O组），每组40例。评定两组治疗疗效，对两组患者治疗后CA125表达情况进行比较，观察两组患者不良反应发生情况。结果 PLD组客观缓解率(ORR)为27.5%（11/40），疾病控制率(DCR)为35.0%（14/40）；G/O组ORR为22.5%（9/40），DCR为27.5%（11/40），差异均无统计学意义(χ2=0.27，P=0.61；χ2=0.52，P=0.47)。PLD组和G/O组患者中达到ORR的患者其CA125值分别为（61.27±28.11）U/ml、（78.29±34.26）U/ml，差异无统计学意义（t=1.22，P=0.24）；未达到ORR的患者其CA125值分别为（530.07±77.15）U/ml、（551.00±78.78）U/ml，差异无统计学意义（t=1.04，P=0.30）。PLD组不良反应主要为手足综合征及骨髓抑制，G/O组不良反应主要为胃肠道反应及骨髓抑制，PLD组患者的白细胞减少（65.0%∶92.5%，χ2=9.04，P=0.005）、血小板减少（15.0%∶52.5%，χ2=12.58，P＜0.001）、贫血（15.0%∶40.0%，χ2=6.27，P=0.012）、胃肠道反应（17.5%∶60.0%，χ2=15.22，P＜0.001）、神经毒性（5.0%∶30.0%，χ2=8.66，P=0.006）不良反应发生率均低于G/O组患者，差异有统计学意义。结论 两种化疗方案对复发性铂耐药卵巢癌患者疗效相当，脂质体多柔比星的不良反应较吉西他滨联合奥沙利铂轻，耐受性更好。

关键词: 卵巢肿瘤, 治疗疗效, 多柔比星

Abstract: Objective To evaluate and compare the efficacy and safety of liposome doxorubicin and gemcitabine combined with oxaliplatin in the treatment of recurrent platinumresistant ovarian cancer. Methods From January 1, 2015 to December 31, 2016, 80 patients from Hunan Cancer Hospital with recurrent platinumresistant ovarian cancer were divided into two groups by using random number table method, 40 cases in each group: group PLD was treated with liposome doxorubicin and group G/O was treated with gemcitabine combined with oxaliplatin. The therapeutic effects of the two groups were evaluated, the expressions of CA125 after treatment were compared and the occurrence of adverse reactions were observed. Results The objective response rate (ORR) and disease control rate (DCR) were respectively 27.5% (11/40) and 35.0% (14/40) in group PLD, and the ORR and DCR were respectively 22.5%（9/40） and 27.5%（11/40） in group G/O, and there was no significant difference between the two groups (χ2=0.27, P=0.61;  χ2=0.52, P=0.47). In PLD group and G/O group, the CA125 values of ORR patients were (61.27±28.11)U/ml and (78.29±34.26)U/ml respectively, with no significant difference (t=1.22, P=0.24), the CA125 values of non ORR patients were (530.07±77.15)U/ml and (551.00±78.78)U/ml respectively, with no significant difference (t=1.04, P=0.30). The main adverse reactions in group PLD were hand foot syndrome and myelosuppression. The main adverse reactions in group G/O were gastrointestinal reaction and myelosuppression. The incidence rates of leucocyte reduction (65.0% vs. 92.5%,  χ2=9.04, P=0.005), thrombopenia (15.0% vs. 52.5%,  χ2=12.58, P＜0.001), anemia (15.0% vs. 40.0%,  χ2=6.27, P=0.012), gastrointestinal reaction (17.5% vs. 60.0%,  χ2=15.22, P＜0.001) and neurotoxicity (5.0% vs. 30.0%,  χ2=8.66, P=0.006) in group PLD were lower than those in group G/O, with significant differences. Conclusion The efficacy of two chemotherapy regimens is similar in patients with recurrent platinumresistant ovarian cancer. Liposome doxorubicin has less adverse reactions than gemcitabine combined with oxaliplatin.

Key words: Ovarian neoplasms, Treatment outcome, Doxorubicin