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目的观察将含铂方案中的单铂改良为双铂联合治疗36例复发卵巢癌以达到等同的疗效和最低的毒副反应。方法经病理组织学或细胞学证实的36例复发卵巢癌患者,采用原来足量单铂联合方案应用一周期后出现较为严重的毒副反应而且出现中断化疗或延期化疗,即改为改良后的双铂联合的方案继续完成化疗,其中改良后的双铂联合的方案为顺铂60mg/m2的1/2量加生理盐水500ml于2h内静滴,第一天,卡铂AUC=5的1/2量加5%葡萄糖注射液500ml于2h内静滴,第八天,同时联合紫杉醇或吉西他滨等非铂类药物,每21d为1周期,至完成化疗后评价疗效及毒副反应和耐受性。结果 36例复发卵巢癌患者均可评价。CR5例,PR9例,总有效率(RR)66.7%。毒副反应评价:主要为骨髓抑制Ⅰ～Ⅱ;白细胞减少Ⅲ～Ⅳ5例,血小板减少Ⅲ～Ⅳ3例经相应处理后均可恢复,胃肠道反应极其轻微,无肝肾功能损害。结论将含铂方案中的单铂改良为双铂联合用于治疗复发卵巢癌与原来含单铂的标准方案比,毒副反应极轻,化疗依从性好,均按期完成预期的化疗周期数,从而使其疗效等同甚至优于原方案,值得一提的是,其极轻的毒副反应可明显改善生活质量,延长生存时间,极易于患者耐受。
OBJECTIVE: To observe the platinum-based regimen of single platinum modified by dual platinum in combination with 36 cases of recurrent ovarian cancer in order to achieve the same effect and the lowest toxicity. Methods 36 cases of recurrent ovarian cancer confirmed by histopathology or cytology were treated with the combination regimen of sufficient single platinum for a period of more serious toxic side effects and interrupted chemotherapy or delayed chemotherapy, The combination of platinum and platinum continue to complete the chemotherapy, in which the improved dual platinum regimen for the cisplatin 60mg / m2 1/2 volume plus saline 500ml 2h intravenous infusion, the first day, carboplatin AUC = 5 of 1 / 2 plus 5% glucose injection 500ml intravenously within 2h, the eighth day, combined with paclitaxel or gemcitabine and other non-platinum drugs every 21d for a cycle to evaluate the efficacy and toxicity after completion of chemotherapy and tolerance Sex. Results 36 cases of recurrent ovarian cancer patients can be evaluated. CR5 cases, PR9 cases, the total effective rate (RR) 66.7%. Toxic and side reaction evaluation: mainly for bone marrow suppression Ⅰ ~ Ⅱ; leukopenia Ⅲ ~ Ⅳ 5 cases, thrombocytopenia Ⅲ ~ Ⅳ 3 cases after treatment can be restored, the gastrointestinal reaction is extremely mild, no liver and kidney dysfunction. Conclusions The platinum-based regimen of single platinum modified to dual platinum for the treatment of recurrent ovarian cancer compared with the original standard solution containing platinum, minimal toxicity, good compliance with chemotherapy, are scheduled to complete the expected number of cycles of chemotherapy, So that its efficacy is equivalent to or even better than the original program, it is worth mentioning that its extremely light side effects can significantly improve the quality of life, prolong survival time, extremely easy to patient tolerance.