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目的:评价联合应用沙利度胺与脂质体阿霉素治疗复发性卵巢上皮性癌和腹膜癌的疗效和毒副作用。方法:将9例经手术和术后泰素+卡铂化疗后复发患者纳入本研究。每4周予以脂质体阿霉素30~50mg/m2化疗,共3~8个疗程;同时每日予以沙利度胺100~300mg,其剂量从100mg/d开始,此后每2周增加50~100mg。通过体检、影像学检查和测定CA125水平评价治疗效果。结果:9例患者的中位年龄为56岁(35~81岁),FIGO分期为ⅢB~Ⅳ期。本次化疗的中位疗程数是6个疗程。中位随访时间为18.5个月。最常见的不良反应为疲劳(55.6%)和神经系统症状(55.6%)。3例患者出现Ⅲ度副反应,1例为无力、1例过敏性皮疹和1例末梢神经感觉异常。根据RECIST标准评价有病灶的6例患者疗效,2例部分缓解,2例治疗中疾病无进展,1例病情进展,1例失访。另有2例CA125升高的患者,在联合化疗3~4个疗程后CA125水平降低50%以上。1例二次肿瘤细胞减灭术后化疗的患者治疗后随访36个月无肿瘤复发迹象。在随访的8例患者中,中位疾病无进展时间为6.5个月(0~36个月);中位总的生存时间为20.5个月(8~36个月)。结论:联合应用沙利度胺与脂质体阿霉素治疗复发性卵巢上皮性癌具有可接受的毒副作用,同时具有一定的治疗效果。
OBJECTIVE: To evaluate the efficacy and side effects of combination of thalidomide and liposomal doxorubicin in the treatment of recurrent epithelial ovarian cancer and peritoneal carcinoma. Methods: Nine patients who undergone surgery and postoperative TAXA + carboplatin recurrence after chemotherapy were enrolled in this study. Every 4 weeks to do liposomal doxorubicin 30 ~ 50mg / m2 chemotherapy, a total of 3 to 8 courses; the same time daily thalidomide 100 ~ 300mg, the dose from 100mg / d, then every 2 weeks increased by 50 ~ 100mg. Through the medical examination, imaging examination and determination of CA125 levels to evaluate the therapeutic effect. Results: The median age of 9 patients was 56 years old (35 ~ 81 years), FIGO stage ⅢB ~ Ⅳ. The median number of courses of chemotherapy is 6 courses. The median follow-up time was 18.5 months. The most common adverse reactions were fatigue (55.6%) and neurological symptoms (55.6%). Three patients had grade III side effects, one was weak, one had an allergic skin rash and one had peripheral sensory abnormalities. According to RECIST criteria, the efficacy of 6 patients with lesions was evaluated, 2 patients were partially relieved, 2 patients had no progression of disease, 1 patient developed disease and 1 patient was lost. Another two patients with elevated CA125 CA125 levels were reduced by more than 50% after 3 to 4 courses of combination chemotherapy. One case of secondary cytoreductive surgery patients after chemotherapy followed up for 36 months without signs of tumor recurrence. Of the 8 patients who were followed, the median progression-free time was 6.5 months (range, 0-36 months); the median overall survival was 20.5 months (range, 8-36 months). Conclusion: The combination of thalidomide and liposomal doxorubicin has an acceptable toxic and side effect in the treatment of recurrent epithelial ovarian cancer, and has a certain therapeutic effect.