目的 评价以吉西他滨为基础联合异环磷酰胺和蒽环类药物治疗复发性铂类耐药卵巢上皮性癌(卵巢癌)的近期疗效及毒副反应.方法 对60例复发性铂类耐药卵巢癌患者应用吉西他滨、异环磷酰胺和蒽环类药物联合化疗方案[吉西他滨800 mg/m2,第1、8天;异环磷酰胺1.5 g/m2,第1～3天;多柔比星(其他名称:阿霉素)40 mg/m2或表柔比星(其他名称:表阿霉素)60 mg/m2(第1天),或米托蒽醌10 mg/m2(第1、8天);21～28 d重复],回顾性分析其临床病理资料.结果 60例患者共接受172个疗程的化疗.完全缓解0例,部分缓解22例(37%,22/60),稳定23例(38%,23/60),疾病进展15例(25%,15/60),临床总获益率75%(45/60);中位无疾病进展生存期为7个月,中位总生存期为20个月.主要不良反应为骨髓抑制,白细胞减少发生率达82%(49/60),其中Ⅲ～Ⅳ度占31%(15/49);消化道反应均为Ⅰ、Ⅱ度,占42%(25/60).结论 以吉西他滨为基础的联合化疗可作为铂类耐药的复发性卵巢癌的治疗方案之一,毒副反应可以耐受.%Objective To evaluate the efficacy and toxicities of gemcitabine combined with ifosfamide and anthracycline chemotherapy for recurrent platinum resistant ovarian epithelial cancer.Methods Gemcitabine 800 mg/m2 ( day 1, 8 ), ifosfamide 1.5 g/m2 ( day 1 - 3 ), adriamycin 40 mg/m2 or epirubicin 60 mg/m2 (day 1 ) or mitoxantrone 10 mg/m2 (day 1, 8 ) were used in recurrent platinum resistant/refractory ovarian cancer patients, the cycle was repeated at interval of 21 to 28 days.Results A total of 60 patients received 172 cycles combined chemotherapy.There were no one cases complete response, while partial response 22 (37%, 22/60), stable 23 (38%, 23/60) and progression 15 (25%,15/60) were observed, with clinical benefit rate 75% (45/60).The median time of progression-free survival was 7 months, and the median overall survival time was 20 months.The main side effect was hematologic toxicity with leukopenia rate of 82% (49/60), among which Ⅲ - Ⅳ accounted for 31%(15/49).Digestive reaction was all in Ⅰ - Ⅱ , accounted for 42% (25/60).Conclusion The regimen of gemcitabine combined with ifosfamide and anthracycline is feasible, tolerable and effective in patients with recurrent platinum resistant/refractory epithelial ovarian cancer.
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