CAJ | 학술논문

　　目的：观察三维适形放疗联合托泊替康化疗治疗铂类耐药复发卵巢上皮癌的疗效及不良反应。方法：回顾性分析2008年6月至2011年6月山东省肿瘤医院收治的铂类耐药复发卵巢上皮癌患者42例，其中三维适形放疗联合托泊替康化疗22例（放化疗组），单药托泊替康化疗20例（单纯化疗组）。放化疗组以15MV X线行三维适形照射，1.8～2.0 Gy/次/d，5次/周，总剂量45～65Gy，平均中位剂量为52.5 Gy。于放疗开始后第1周行托泊替康化疗2.0 mg/m2，第1、8、15天给药，每28天重复。单纯化疗组于第1周开始行托泊替康化疗4.0 mg/m2，第1、8、15天给药，每28天重复。结果：放化疗组、单纯化疗组中位随访时间分别为18.5（2～37.7）个月、10.8（1.5～29.6）个月；总缓解率分别为42.1%（8/19）、11.1%（2/18）；临床获益率分别为68.4%（13/19）、22.2%（4/18），两组比较有显著性差异（P<0.05）。中位疾病无进展期分别为9.8、6.6个月，两组比较有显著性差异（P<0.001）。中位生存期分别为19.7、12.5个月，两组比较有显著性差异（P<0.05）。Ⅲ度消化道反应发生率分别为26.3%（5/19）、16.7%（3/18）；Ⅲ～Ⅳ级血液学毒性发生率分别为21.1%（4/19）、22.2%（4/18），两组比较无显著性差异（P>0.05）。结论：三维适形放疗联合托泊替康化疗对铂类耐药复发卵巢上皮癌有较好的疗效，且不良反应轻微，可作为复发患者的补救治疗措施。
　　목적：관찰삼유괄형방료연합탁박체강화료치료박류내약복발란소상피암적료효급불량반응。방법：회고성분석2008년6월지2011년6월산동성종류의원수치적박류내약복발란소상피암환자42례，기중삼유괄형방료연합탁박체강화료22례（방화료조），단약탁박체강화료20례（단순화료조）。방화료조이15MV X선행삼유괄형조사，1.8～2.0 Gy/차/d，5차/주，총제량45～65Gy，평균중위제량위52.5 Gy。우방료개시후제1주행탁박체강화료2.0 mg/m2，제1、8、15천급약，매28천중복。단순화료조우제1주개시행탁박체강화료4.0 mg/m2，제1、8、15천급약，매28천중복。결과：방화료조、단순화료조중위수방시간분별위18.5（2～37.7）개월、10.8（1.5～29.6）개월；총완해솔분별위42.1%（8/19）、11.1%（2/18）；림상획익솔분별위68.4%（13/19）、22.2%（4/18），량조비교유현저성차이（P<0.05）。중위질병무진전기분별위9.8、6.6개월，량조비교유현저성차이（P<0.001）。중위생존기분별위19.7、12.5개월，량조비교유현저성차이（P<0.05）。Ⅲ도소화도반응발생솔분별위26.3%（5/19）、16.7%（3/18）；Ⅲ～Ⅳ급혈액학독성발생솔분별위21.1%（4/19）、22.2%（4/18），량조비교무현저성차이（P>0.05）。결론：삼유괄형방료연합탁박체강화료대박류내약복발란소상피암유교호적료효，차불량반응경미，가작위복발환자적보구치료조시。
Objective: This study aims to observe the efficacy and toxicity of three-dimensional conformal radiotherapy (3DCRT) combined with weekly topotecan hydrochloride (Top-Hyd) chemotherapy on patients with platinum-resistant recurrent ovarian cancer. Methods: Medical data of 42 patients with platinum-resistant recurrent ovarian cancer between June 2008 and June 2011 were retrospectively reviewed. OAOf these 42 patients, 22 underwent 3DCRT combined with weekly Top–Hyd chemotherapy, whereas the remaining 20 underwent simple chemotherapy (SCT). Doses from 45 Gy to 65 Gy were planned to deliver fractions ranging from 1.8 Gy to 2 Gy to patient abdomen and pelvis. Top–Hyd (4 mg/m2) was aintravenously administered 1, 8, and 15 days from radiotherapy, with a cycle of 28 days. Results: By December 31, 2011, the median follow-up time for the 3DRT group was 18.5 months, whereas that for the SCT group was 10.8 months . The total response rate and the clinical beneficial rate were significantly higher in the 3DCRT group than in the SCT group (total response rate, 42.1% vs. 11.1%; clinical beneficial rate, 68.4% vs 22.2% at P< 0.05). The median of progression-free survival time was 9.8 months for the 3DCRT group and 6.6 months for the SCT group. The median total survival time was 19.7 months in the 3DCRT group, and 12.5 months in the SCT group. Significant differences between the 2 groups were indicated (P<0.001). No significant difference in overall toxicity was indicated between the two groups (P>0.05). Conclusion: The combined 3DCRT treatment and Top-Hyd chemotherapy results in enhanced response and tolerable toxicity compared with SCT in patients with recurrent ovarian cancer infiltrating the pelvic and retroperitoneal lymph node metastasis. So, it may be the salvage regimen for recurrent ovarian cancer and provide a new therapeutic option for the consolidation treatment of advanced ovarian carcinoma.