对未接受过化疗的晚期卵巢癌患者行吉西他滨、紫杉醇和顺铂联合化疗的多中心Ⅱ期研究

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Objectives. The objectives of this multicenter phase II study were to evaluate the effects of gemcitabinepaclitaxel- cisplatin combination chemotherapy on response rate, survival, and toxicity in patients with advanced epithelial ovarian cancer (AEOC). Methods. Chemonaive AEOC patients with bidimensionally measurable disease or an elevated serum cancer antigen 125 level received cisplatin (70 mg/m2)onday 1 and paclitaxel (80 mg/m 2) and gemcitabine (1000 mg/m2)pacli- on days 1 and 8, every 3 weeks. Results. Between October 2000 and September 2001, 46 patients were enrolled. Sixteen patients underwent debulking surgery prior to chemotherapy. In 45 evaluable patients, overall response rate was 64.4% (7 CR and 22 PR). Median time- to- progression was 13.4 months (95% CI, 9.6- 17.4 months); median progression- free survival was 12.3 months (95% CI, 8.8- 15.6 months); median overall survival was 26.0 months (95% CI, 18 months- not reached); and 1- year survival was 74% (95% CI, 60- 88% ). The relative dose intensities of gemcitabine, paclitaxel, and cisplatin were 81.4% , 80.2% , and 89.8% , respectively. Grade 3/4 neutropenia was the predominant hematologic toxicity observed (73.9% of patients) followed by grade 3/4 leukopenia (56.5% ), anemia (45.7% ), thrombocytopenia (23.9% ), and febrile neutropenia/neutropenic sepsis (26.1% ). The predominant grade 3 nonhematologic toxicities were alopecia (43.5% ) and diarrhea (19.6% ). Grade 4 nonhematologic toxicities were nausea/vomiting, constipation, and uremia (2.2% each). Two treatment- related deaths occurred (neutropenic sepsis and uremia). Conclusion. Gemcitabine- paclitaxel- cisplatin combination chemotherapy is active with manageable toxicity in chemonaive patients with advanced ovarian cancer and should be explored in larger phase III trials. Objectives. The objectives of this multicenter phase II study were to evaluate the effects of gemcitabinepaclitaxel-cisplatin combination chemotherapy on response rate, survival, and toxicity in patients with advanced epithelial ovarian cancer (AEOC). Methods. Chemonaive AEOC patients with bidimensionally measurable disease or an elevated serum cancer antigen 125 level received cisplatin (70 mg / m2) onday 1 and paclitaxel (80 mg / m2) and gemcitabine (1000 mg / m2) pacli-on days 1 and 8, every 3 weeks. Sixteen patients underwent debulking surgery prior to chemotherapy. In 45 evaluable patients, overall response rate was 64.4% (7 CR and 22 PR). Median time- to- progression was 13.4 months (95% confidence interval, Median progression-free survival was 12.3 months (95% CI, 8.8- 15.6 months); median overall survival was 26.0 months (95% CI, 18 months- not reached); and 1- year survival was 74% (95% CI, 60- 88%) Grade 3/4 neutropenia was the predominant hematologic toxicity observed (73.9% of patients) followed by grade 3/4 leukopenia (56.5 The predominant grade 3 nonhematologic toxicities were alopecia (43.5%) and diarrhea (19.6%). Grade 4 nonhematologic toxicities were (%)) anemia (45.7%), thrombocytopenia (23.9%), and febrile neutropenia / neutropenic sepsis Conclusion Two treatments-related deaths occurred (neutropenic sepsis and uremia). Conclusion. Gemcitabine-paclitaxel-cisplatin combination chemotherapy is active with manageable toxicity in chemonaive patients with advanced ovarian cancer and should be explored in larger phase III trials.
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期刊
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