JCO:培美曲塞联合顺铂治疗晚期宫颈癌安全有效

2014-08-06 hujie 丁香园

子宫颈癌一旦转移或复发,手术或放射治疗的预后都不尽如人意,治疗药物的方案选择还不很成熟,单独或者联合使用哪种药物最有效还是未知。培美曲塞和顺铂都是抗癌药物,在多种癌症的治疗中都表现不俗,至于在治疗顽固性或复发性宫颈癌中是否有效安全不得而知。 美国德克萨斯大学西南医学中心的Miller教授等开展了一项有限人数的二期临床试验,评价了培美曲塞和顺铂的联合作用,结果显示二者联合应用在治疗晚期顽固

宫颈癌一旦转移或复发,手术或放射治疗的预后都不尽如人意,治疗药物的方案选择还不很成熟,单独或者联合使用哪种药物最有效还是未知。培美曲塞顺铂都是抗癌药物,在多种癌症的治疗中都表现不俗,至于在治疗顽固性或复发性宫颈癌中是否有效安全不得而知。

美国德克萨斯大学西南医学中心的Miller教授等开展了一项有限人数的二期临床试验,评价了培美曲塞和顺铂的联合作用,结果显示二者联合应用在治疗晚期顽固性或复发性子宫颈癌是有效的,耐受性好。本篇文章于7月28日发表在J Clin Oncol上。

本次研究共纳入晚期顽固性或复发性子宫颈癌有效病人54例,病人先按照500mg/m2的量静脉注射的培美曲塞,10分钟之后立即以小于每分钟1mg的速度静脉注射顺铂,在4小时之内将总共50 mg/m2的顺铂全部注射完毕,21天为一个周期,培美曲塞治疗前7天,补充叶酸和维生素B12。当出现疾病进展或者出现严重的不良事件时治疗即被终止。

结果显示,平均每个病人接受了6.2个周期的化疗,有29%的病人接受了9个或者更多的治疗周期。治疗方案较好耐受,其中不良反应主要为贫血,胃肠道症状,恶心等。三级及以上不良反应包括中性粒细胞减少(35%),白细胞减少(28%),代谢(28%)。总应答率为31%,包括1例完全缓解和16例部分缓解。中位无进展生存期为5.7个月,总存活期为12.3个月。

研究结果表明,培美曲塞联合顺铂是有效的治疗晚期顽固性或者复发性宫颈癌的方案,且该方案安全性良好。这一结果将会对未来的宫颈癌治疗产生指导意义。

原始出处:

Miller DS1, Blessing JA2, Ramondetta LM2, Pham HQ2, Tewari KS2, Landrum LM2, Brown J2, Mannel RS2.Pemetrexed and Cisplatin for the Treatment of Advanced, Persistent, or Recurrent Carcinoma of the Cervix: A Limited Access Phase II Trial of the Gynecologic Oncology Group.J Clin Oncol. 2014 Jul 28. pii: JCO.2013.54.7448. [Epub ahead of print]

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    2014-12-19 lidong40
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    2014-08-08 一闲
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