Efficacy In The Treatment Of Recurrent Ovarian Cancer Of Different Drug Combination Nedaplatin

BackgroundOvarian cancer is common in gynecological malignant tumor, the mortality rate ashigh as47%in gynecologic malignant tumors, but about70%of patients found that arealready in advanced ovarian cancer (III, IV), the first treatment including maximum tumorcells to destroy the loss, and supplemented by platinum based on MDT. Although first-linechemotherapy effective ratio is higher, but most patients receiving first-lineplatinum-based drugs often relapse after treatment, and shall no longer accept two lines,three lines or more chemotherapy regimens. And the remedy of low efficiency, also had ashorter remission. So the curative effect is good to recurrent ovarian cancer chemotherapyhelps to improve the patient’s quality of life, prolong the survival time, has clinicalsignificance in reality.PurposeResearch paclitaxel liposome combined with nedaplatin and docetaxel combinedwith nedaplatin and gemcitabine combined nedaplatin efficacy of the treatment ofrecurrent ovarian cancer.Methods(1) ChemotherapyFirst day: paclitaxel liposomes (force plain, each bottle containing paclitaxel30mg)130~170mg m-2(multi-docetaxel60~100mg m-2, gemcitabine900~1100mg m-2),add5%glucose injection500mL3h complete intravenous infusion; next day: nedaplatin85to105mg m-2, and0.9%sodium chloride injection500mL, intravenous, and shall notbe less than1h infusion to continue，after the completion of the intravenous infusion of0.9%sodium chloride injection1000ml or more, in order to ensure adequate urine output,thereby reducing urine drug tubular damage. Gemcitabine treatment programshould usegemcitabine again in the same way on the eighth day.The program is repeated every21days. Each patient for at least two cycles, and each cycle evaluation of the efficacy, ifdeteriorates, they should stop the chemotherapy. Each cycle, the evaluation of adversereactions, the white blood cells or platelets reduce the patients may be secondary to granulocyte set off the stimulus factor or granulocyte cells-macrophages set drop-stimulating factor support treatment if appears WHO as defined in the Ⅲ~Ⅳd egree of to-xicity, dose intensity of cyt otoxic drugs should be adjusted to75%, still appear after thetoxic dose adjustment to75%, should terminate the chemotherapy.(2) Pre-symptomatic treatment12h and6h before the use of Taxane must given dexamethasone tablets20mg,30minbefore the use of the combination of drugs given intramuscular diphenhydramine (20mg),cimetidine (0.2mg the20mL infusion of0.9%sodium chloride injection), promethazine(25mg intramuscular injection), dexamethasone (5~10mg intravenous), in order to alleviatethe symptoms of the gastrointestinal tract, patients usually given in the application of drugtreatment (5-HT3) receptor antagonists.Result(1) Paclitaxel liposome combined with nedaplatin:the treatment of ovarian cancer, the total effective rate of62.5%,the platinum-resistantflu group and the platinum-sensitive group chemotherapy efficiency of60%and64.28%,The numble of survival patients was29.In this experiment,the major toxicitiesinclude myelosuppression,gastrointestinal reactions, and hair loss.(2) Docetaxel combined Nedaplatin:the treatment of ovarian cancer, the total effect-tive rate was66.67%， theplatinum-resistant flu group and the platinum-sensitive group chemotherapy efficiency of57.14%and74.07%respectively.The numble of survival patients was25.This experiment,the major toxicities include myelosuppres-sion, gastrointestinal reactions, peripheral nerveparesthesia, muscle and joint pain, and hair loss.(3) Gemcitabine combined with nedaplatin:the treatment of ovarian cancer, the total effective rate was64.00%, the platinumresistant flu group and the platinum-sensitive group chemotherapy efficiency of55.56%and68.75%respectively.The numble of survival patients was14.The major toxicity in thisexperiment mainly bone marrow suppression and gastrointestinal reactions.Conclusion(1) Paclitaxel liposome combined with nedaplatin and docetaxel combined withnedaplatin and gemcitabine combined nedaplatin have a certain effect on treatment ofovarian cancer.(2) From the point of view of clinical curative effect, the three programs totalefficiency almost were: paclitaxel liposome combined with nedaplatin (62.5%), docetaxel combined nedaplatin (66.67%), gemcitabine combined nedaplatin (64.00%). The efficacyof platinum-sensitive patients resistant of the three programs is better in platinum-resistantflu patients, especially docetaxel combined with nedaplatin program.(3) The quality score of the three programs and the long-term efficacy are similar, notvery different.(4) Paclitaxel liposome combined with nedaplatin program major toxicities includemyelosuppression,gastrointestinal reactions,muscle pain, and hair loss; docetaxel combinedwith nedaplatin program including bone marrow suppression,gastrointestinal toxicityreactions, peripheral nerve paresthesia, muscle and joint pain,and hair loss; major toxicitiesof gemcitabine plus nedaplatin program primarily bone marrow suppression andgastrointestinal reactions. As can be seen from the above, the third option,the least toxicity.