Efficacy of taxane and platinum-based chemotherapy guided by extreme drug resistance assay in patients with epithelial ovarian cancer
Efficacy of taxane and platinum-based chemotherapy guided by extreme drug resistance assay in patients with epithelial ovarian cancer
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DOI：
10.3802/jgo.2009.20.2.96
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发表时间：
2009-06-01
影响因子：
3.9
通讯作者：
Nam, Joo-Hyun
中科院分区：
文献类型：
--
作者：
Joo, Won Deok;Lee, Ji Young;Nam, Joo-Hyun
目的：方法：选择2004年8月至2006年8月在峨山医学中心接受紫杉烷联合铂类化疗的卵巢上皮癌患者39例，均为卵巢上皮癌、输卵管癌或原发性腹膜癌，均行肿瘤减瘤术和紫杉烷联合铂类化疗。另外39名患者入组，他们没有接受Ehrs作为对照。治疗组和对照组均给予紫杉醇175 mg/m2和卡铂AUC 5作为初始联合化疗。如果患者对紫杉醇而非多西他赛表现出极端耐药（EDR），则依西他赛组用多西他赛75 mg/m2替代紫杉醇。如果患者对卡铂显示EDR而对顺铂未显示EDR，则用顺铂75 mg/m2替代卡铂。如果只有一种药物显示低耐药性（LDR），则允许添加另一种显示LDR的药物，如吉西他滨1，000 mg/m2。结果：治疗组总有效率为84.5%，对照组总有效率为71.8%，两组比较差异无统计学意义（P=0.107）。而紫杉醇组93.8%的患者对至少一种药物未显示EDR，其有效率显著高于对照组（93.3%vs.71.8%，p=0.023）。结论：紫杉醇联合铂类治疗卵巢癌可选择无EDR的方案，且疗效较好。
Objective: To evaluate the efficacy of taxane and platinum-based chemotherapy guided by extreme drug resistance assay (EDRA) in patients with epithelial ovarian cancer.Methods: Thirty-nine patients were enrolled, who were diagnosed as epithelial ovarian cancer, tubal cancer or primary peritoneal carcinoma and received both debulking surgery and EDRA in Asan Medical Center between August 2004 and August 2006. Another thirty-nine patients were enrolled, who did not receive EDRA as control. Paclitaxel 175 mg/m(2) and carboplatin AUC 5 were administered as primary combination chemotherapy to both EDRA group and the control group. In the EDRA group, paclitaxel was replaced by docetaxel 75 mg/m(2) if a patient showed extreme drug resistance (EDR) to paclitaxel and not to docetaxel. Carboplatin was replaced by cisplatin 75 mg/m if a patient showed EDR to carboplatin and not to cisplatin. If only one drug showed low drug resistance (LDR), it was allowed to add another drug which showed LDR such as gemcitabine 1,000 mg/m(2). CT scan was performed every three cycles and CA-125 was checked at each cycle.Results: There was no significant difference in overall response rate between EDRA group and the control group (84.5% vs. 71.8%, p=0.107). However, 93.8% of patients in EDRA group did not show EDR to at least one drug and its response rate was significantly higher than that of the control group (93.3% vs. 71.8%, p=0.023).Conclusion: we could choose a combination of taxane and platinum which did not show EDR and could obtain a good response in the patients with ovarian cancer.