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目的 :观察依维莫司治疗复发难治性骨肉瘤与软组织肉瘤的临床疗效和安全性。方法:这是一项回顾性研究。2014年1月—2015年8月收治的20例二线放化疗失败的复发难治性骨肉瘤与软组织肉瘤患者接受依维莫司治疗(10 mg/次,1次/d,28 d为1个治疗周期);如患者发生不可耐受的不良反应,可减量至5 mg/次,1次/d。评价依维莫司治疗的疗效和安全性。结果:20例患者中,骨肉瘤10例,软组织肉瘤10例(腺泡状软组织肉瘤2例、上皮样肉瘤2例、黏液纤维肉瘤1例、滑膜肉瘤1例、梭形细胞肉瘤1例、尤文肉瘤1例、恶性神经鞘瘤2例)。依维莫司治疗后,部分缓解5例,疾病稳定10例,疾病进展4例,疾病控制率为75%(15/20)。20例患者的中位无进展生存时间为46 d(95%可信区间:29~63 d),中位生存时间为56 d(95%可信区间:33~79 d)。10例软组织肉瘤患者和10例骨肉瘤患者的中位无进展生存时间分别为35 d和56 d,中位生存时间分别为84 d和140 d。主要的不良反应包括口腔炎(80%)、胃肠反应(30%)、皮疹(25%)和乏力(25%)。结论:依维莫司治疗复发难治性骨肉瘤与软组织肉瘤可取得一定的疗效,不良反应较轻,耐受良好。
Objective: To observe the clinical efficacy and safety of everolimus in the treatment of relapsed and refractory osteosarcoma and soft tissue sarcoma. Method: This is a retrospective study. From January 2014 to August 2015, 20 patients with recurrent refractory osteosarcoma and soft tissue sarcoma who had failed second-line radiotherapy and chemotherapy were treated with everolimus (10 mg once daily for 28 days) Treatment cycle); If patients with intolerable adverse reactions, can be reduced to 5 mg / time, 1 time / d. To evaluate the efficacy and safety of everolimus treatment. Results: Of the 20 patients, 10 had osteosarcoma, 10 had soft tissue sarcoma (2 in acinar soft tissue sarcoma, 2 in epithelioid sarcoma, 1 in mucinous fibrosarcoma, 1 in synovial sarcoma, 1 in spindle cell sarcoma, Ewing sarcoma in 1 case, 2 cases of malignant schwannoma). After everolimus treatment, partial remission in 5 cases, 10 cases of stable disease, disease progression in 4 cases, the disease control rate was 75% (15/20). The median progression-free survival time for the 20 patients was 46 days (95% confidence interval: 29-63 days) and median survival time was 56 days (95% confidence interval: 33-79 days). The median progression-free survival of 10 patients with soft tissue sarcoma and 10 patients with osteosarcoma was 35 d and 56 d, respectively. The median survival time was 84 d and 140 d, respectively. The main adverse reactions include stomatitis (80%), gastrointestinal reaction (30%), rash (25%) and fatigue (25%). Conclusion: The treatment of everolimus refractory osteosarcoma and soft tissue sarcoma can achieve a certain effect, mild adverse reactions, well tolerated.