聚乙二醇化脂质体多柔比星联合异环磷酰胺治疗晚期转移性软组织肉瘤

doi:10.19401/j.cnki.1007-3639.2017.09.002

中国癌症杂志 ›› 2017, Vol. 27 ›› Issue (9): 687-692.doi: 10.19401/j.cnki.1007-3639.2017.09.002

聚乙二醇化脂质体多柔比星联合异环磷酰胺治疗晚期转移性软组织肉瘤

刘　欣，张晓伟，王惠杰，吴向华，罗志国

复旦大学附属肿瘤医院肿瘤内科，复旦大学上海医学院肿瘤学系，上海200032

出版日期:2017-09-30 发布日期:2017-09-27
通信作者: 罗志国　E-mail：luozhiguo88@163.com

Pegylated liposomal doxorubincin combined with ifosfamide as first-line treatment for patients with advanced or metastatic soft tissue sarcoma

LIU Xin, ZHANG Xiaowei, WANG Huijie, WU Xianghua, LUO Zhiguo

Department of Medical Oncology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

Published:2017-09-30 Online:2017-09-27
Contact: LUO Zhiguo E-mail: luozhiguo88@163.com

摘要/Abstract

摘要： 背景与目的：软组织肉瘤一旦出现远处转移，预后极差，中位生存时间不到1年。多柔比星联合异环磷酰胺(ifosfamide，IFO)(AI方案)是晚期软组织肉瘤常用的一线联合治疗方案。聚乙二醇脂质体多柔比星(pegylated liposomal doxorubicin，PLD)活性成分为盐酸多柔比星，药物包裹在脂质体中，可减少多柔比星的临床毒性反应。该研究探讨PLD联合IFO治疗晚期转移性软组织肉瘤的临床疗效和安全性。方法：选取晚期转移性软组织肉瘤患者25例，使用PLD联合IFO方案，PLD剂量30 mg/m²，静脉滴注，第1天；IFO剂量1.8 g/m²，静脉滴注，第1~5天；美司钠360 mg/m²，用IFO时0、4和8 h，21 d为1个周期。结果：所有患者化疗1~8个周期，中位周期数4。25例患者中部分缓解9例(36%)，疾病稳定12例(48%)，疾病进展4例(16%)，疾病控制率(完全缓解+部分缓解+疾病稳定)为84%(21/25)。中位无进展生存时间为7.3个月(95%CI：4.6~10.0个月)。由于失访病例较多，中位总生存时间未随访到。化疗后3/4级不良反应包括白细胞下降(20%)、粒细胞下降(28%)、贫血(4%)和呕吐(4%)。只有1例患者治疗过程中予以减量。结论：临床应用PLD联合IFO方案治疗晚期转移性软组织肉瘤疗效确切，且毒性反应较轻，值得进一步深入研究。

关键词: 聚乙二醇化脂质体多柔比星, 异环磷酰胺, 晚期, 转移性, 软组织肉瘤

Abstract: Background and purpose: Patient with metastatic soft tissue sarcoma has a poor prognosis with median survival time of less than 1 year. Doxorubicin combined with ifosfamide (IFO) (AI regimen) is frequently used in the first-line treatment for patients with metastatic soft tissue sarcoma. Pegylated liposomal doxorubicin (PLD) is the liposomal formulation of doxorubicin and has exhibited less toxicity. Therefore our study was aimed to evaluate the efficacy and safety of PLD combined with IFO as the first-line treatment for patients with advanced or metastatic soft tissue sarcoma (STS). Methods: A total of 25 chemotherapy-naive patients with advanced or metastatic STS were enrolled in this study between November 2013 and December 2015. All patients received treatment of PLD 30 mg/m², d1, plus IFO 1.8 g/m², d1-5, repeatedly every 21 days. Results: All patients received 1-8 cycles of treatment, at a median of 4 cycles. Among 25 patients, partial response was observed in 9 patients (36%), stable disease (SD) was observed in 12 patients (48%) and progressive disease (PD) in 4 patients (16%). The disease control rate (DCR, CR+PR+SD) was 84%. The median progression-free survival (PFS) was 7.3 months (95%CI, 4.6 to 10.0 months). The grade 3/4 toxicities included leukopenia (20%), neutropenia (28%), anemia (4%) and vomiting (4%). Conclusion: Combination therapy comprising PLD and IFO was effective and well tolerated as first-line treatment for patients with advanced or metastatic STS, which warrants further research.

Key words: Pegylated liposomal doxorubicin, Ifosfamide, Advanced, Metastatic, Soft tissue sarcoma

刘　欣,张晓伟,王惠杰,等. 聚乙二醇化脂质体多柔比星联合异环磷酰胺治疗晚期转移性软组织肉瘤[J]. 中国癌症杂志, 2017, 27(9): 687-692.

LIU Xin, ZHANG Xiaowei, WANG Huijie, et al. Pegylated liposomal doxorubincin combined with ifosfamide as first-line treatment for patients with advanced or metastatic soft tissue sarcoma[J]. China Oncology, 2017, 27(9): 687-692.

[1]	汪　明, 曹　晖. 晚期胃肠间质瘤药物治疗进展[J]. 中国癌症杂志, 2021, 31(2): 90-99.
[2]	郭　晔, 张陈平 . 抗EGFR单抗治疗复发/转移性头颈部鳞状细胞癌临床共识（2021年版）[J]. 中国癌症杂志, 2021, 31(12): 1220-1232.
[3]	卢大松, 冯勇军, 王武峰, 牟忠林, 赵　娜. 个体化营养干预对局部晚期鼻咽癌患者生活质量及生存预后的影响[J]. 中国癌症杂志, 2021, 31(12): 1202-1208.
[4]	沈　洁, 莫　淼, 袁　晶, 周昌明, 王泽洲, 张志红, 温　灏, 吴小华, 郑　莹 . 1 313例局部晚期宫颈癌患者的长期生存报告：以医院为基础的真实世界研究[J]. 中国癌症杂志, 2020, 30(3): 192-198.
[5]	林瑾仪, 王　妍, 侯惠萍, 周宇红, 刘天舒, 程蕾蕾 . 软组织肉瘤患者可溶性ST2的临床价值：一项单中心横断面研究[J]. 中国癌症杂志, 2020, 30(12): 996-1001.
[6]	卞晓洁, 沈益君, 朱一平, 马春光, 顾成元, 叶定伟. 晚期尿路上皮癌二线系统治疗方案的生命质量真实世界数据分析：替雷利珠单抗单药对比二线化疗[J]. 中国癌症杂志, 2020, 30(10): 798-805.
[7]	吴　佳　, 周嘉梁　 . 西妥昔单抗在转移性结直肠癌一线治疗后的后续应用研究进展[J]. 中国癌症杂志, 2020, 30(1): 64-69.
[8]	杨凌舸?,王春萌? . 腺泡状软组织肉瘤药物治疗现状与进展[J]. 中国癌症杂志, 2019, 29(9): 746-752.
[9]	陈嘉莹，王卓颖 . 原发不明的颈部转移性癌的诊治进展[J]. 中国癌症杂志, 2019, 29(6): 457-462.
[10]	罗春莉　,李志平　 . 软组织肉瘤的分子靶向治疗研究进展[J]. 中国癌症杂志, 2019, 29(10): 824-831.
[11]	郑营营,徐俊彦,张建平,等. ¹⁸F-FDG PET/CT纹理分析预测局部晚期直肠癌新辅助放化疗疗效的价值[J]. 中国癌症杂志, 2018, 28(8): 590-594.
[12]	马英超,刘津灵,王巍. 实时剪切波弹性成像在鉴别淋巴瘤与转移性淋巴结中的应用价值[J]. 中国癌症杂志, 2018, 28(7): 520-524.
[13]	顾筱莉,成文武,陈萌蕾,等. 晚期癌症患者中医辨证分型分布及其同生存期的相关性分析研究[J]. 中国癌症杂志, 2018, 28(7): 532-537.
[14]	李玲,马桂霞,司壮丽,等. 甲氧氯普胺联合氟哌啶醇改善癌性恶心呕吐及乏力的临床研究[J]. 中国癌症杂志, 2018, 28(5): 394-400.
[15]	孙　馨,郭　卫,杨荣利,等. 单中心高度恶性软组织肉瘤的诊疗经验[J]. 中国癌症杂志, 2018, 28(3): 210-215.

聚乙二醇化脂质体多柔比星联合异环磷酰胺治疗晚期转移性软组织肉瘤

Pegylated liposomal doxorubincin combined with ifosfamide as first-line treatment for patients with advanced or metastatic soft tissue sarcoma

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价