| Purpose:To evaluate the efficacy and safety of Pemetrexed disodium in the treatment of recurrent epithelial ovarian cancer,fallopian tube cancer,and primary peritoneal cancer.Methods:Patients with recurrent epithelial ovarian cancer who received pemetrexed disodium chemotherapy at Qilu Hospital of Shandong University between January 2015 and December 2019 were identified.All patients were given folic acid supplement treatment during the treatment period of intravenous infusion chemotherapy with pemetrexed disodium.Dose delay and adjustment were permitted when serious side effects occurred.To observe the efficacy rate and follow up on its side effects,progression-free survival and overall survival after chemotherapy were monitored.Results:A total of 96 cases were collected,and 340 cycles of chemotherapy(median 3 cycles,range 1-9 cycles)were administered.The overall response rate(ORR)was 32.3%(31 cases),where 16 patients(16.67%)had a complete response,and 15 patients(15.62%)had a partial response.And 29(30.21%)patients had stable disease,with a total disease control rate of 62.5%,while 37.5%(36 cases)had disease progression.The overall response rate of 28 platinum-sensitive ovarian cancer patients was 42.85%,where 9 patients had a complete response,and 3 patients had a partial response.The overall response rate of 68 platinum-resistant ovarian cancer patients was 27.94%,where 7 patients had a complete response,and 12 patients had a partial response.There was no significant difference between platinum-sensitive and platinum-resistant ovarian cancer patients' ORRs(42.85%vs 27.94%,P=0.16).The median progression-free survival(PFS)was 3.52 months and 2.97 months(P=0.06),respectively,and there was no significant difference.The median overall survival(OS)of the two groups was 36 months and 18 months,respectively,and the difference was statistically significant(P=0.01).The overall response rates(ORRs)of pemetrexed disodium combined with lobaplatin,nedaplatin,carboplatin or cisplatin used in platinum-sensitive ovarian cancer patients ware 50%,66.67%,33.33%and 40%,respectively,P= 0.838.There was no significant difference between these four groups.In platinum-resistant ovarian cancer patients,there was no significant difference in the therapeutic effect of pemetrexed combined with loplatin,pemetrexed combined with oxaliplatin and pemetrexed alone(ORR was 20%,29.41%,11.11%,P=0.67).The therapeutic effect of pemetrexed combined with nedaplatin was better than that of pemetrexed combined with loplatin(ORR:61.54%vs 20%,P=0.028),and better than that of pemetrexed alone(ORR:61.54%vs 11.11%,P=0.025),but similar to that of pemetrexed combined with oxaliplatin(ORR:61.54%vs 29.41%,P=0.138).There was no drug-related death in all patients,and all of the side effects were mild.The most common side effects were myelosuppression,gastrointestinal reaction and hepatotoxicity,where the grade 1 and 2 side effects were the most common.The incidence of leukopenia,neutropenia and thrombocytopenia of grade 3 and above were 4.41%,6.47%and 1.18%,respectively.The gastrointestinal reaction was common in mild nausea,vomiting,diarrhea,constipation and other gastrointestinal disorders,with a total incidence of 24.71%.One patient prolonged the chemotherapy cycle due to grade 2 damage of liver function;one patient prolonged the chemotherapy cycle and reduced the dosage of pemetrexed disodium due to severe anemia and grade 3 thrombocytopenia;one patient reduced the dosage of pemetrexed disodium due to grade 4 neutropenia and grade 3 thrombocytopenia;one patient prolonged the chemotherapy cycle due to grade 3.thrombocytopenia.Conclusion:Pemetrexed disodium has a certain effect in chemotherapy of refractory and recurrent epithelial ovarian cancer,and the side effects are tolerable.Pemetrexed disodium may be a choice for refractory and recurrent ovarian cancer. |
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