Platinum sensitive 재발성 난소암에서 Carboplatin/Paclitaxel의 효과 = The Response Rate of Carboplatin/Paclitaxel for the Platinum Sensitive Recurrent Ovarian Cancer Patients

국문 초록 (Abstract)

목적 : 재발성 난소암에서 platinum 감수성을 기준으로 2차 항암요법으로 사용한 Carboplatin과 Paclitaxel의 효과를 알아보기 위하여 본 연구를 진행하였다.
연구방법 : 1998년 1월 1일부터 2003년 8월 31일까지 만 5년 8개월 간 아주대학교병원 산부인과에 재발성 난소암으로 입원한 환자 중에서 최초 수술로 난소암을 확진한 후 Cisplatin 또는 Carboplatin 등 platinum 제재가 포함된 항암치료를 받은 후 6개월 이후에 재발한 환자 29명을 대상으로 Carboplatin은 5 AUC를 그리고 Paclitaxel은 175 mg/m^(2)를 투여하였으며, 최소 3회에서 최고 16회까지 투여하였다. 치료효과의 판정은 CT, MRI, Ultrasonography등 영상진단상 암종괴의 크기가 완전히 소실되었을 경우를 완전반응(complete response)으로, 50%이상 감소되었을 경우를 부분반응(partial response)으로, 50% 미만으로 감소되었거나 20% 미만 증가하였을 경우를 불변(stable disease)으로, 그리고 20% 이상 증가되었을 경우를 진행(progressive disease)로 정의하였다.
결과 : 대상 환자에서 완전반응은 6명(21%), 부분반응은 11명(38%), 그리고 불변은 5명(17%)로 전체 반응율 (overall response rate)은 59% 그리고 임상적 유용성(clinical benefit=CR+PR+SD)은 76%이었다.
결론 : 재발성 난소암환자에서 기왕에 사용한 Platinum 제재에 민감한 환자에서는 Carboplatin과 Paclitaxel의 병행 투여가 효과적이었다.

다국어 초록 (Multilingual Abstract)

Objective : To ascertain the effect of Carboplatin and Paclitaxel combination as a second line regimen for recurrent ovarian carcinoma based on platinum sensitivity.
Methods : From January 1st, 1998 through to August 31st, 2003, 29 patients were retrospectively reviewed who had previously underwent primary cytoreductive surgery and adjuvant chemotherapy with Cisplatin or Carboplatin for ovarian carcinoma, and who had later recurred during follow up. All 29 patients had recurred at least 6 months after therapy, and thereafter received second line chemotherapy consisting of Carboplatin (5 AUC) and Paclitaxel (175 mg/㎡) for a minimum of least 3 cycles and a maximum of 16 cycles. Treatment efficacy was assessed by imaging studies including Computerized tomography, Magnetic Resonance Imaging, or Ultrasonography. Complete response was determined as complete disappearance of tumor, partial response at least than 50% reduction in tumor volume, stable disease as less than 50% reduction or less than 20% increase in tumor volume, and progressive disease as more than 20% increase.
Results : There was complete response in 6 (21%) patients, partial response in 11 (38%), stable disease in 5 (17%), showing an overall response rate of 59%. The clinical benefit (CR+PR+SD) was 76%.
Conclusion : The combination of Carboplatin and Paclitaxel administration seems to be an effective mode of second line therapy in patients with recurrent ovarian carcinoma who had been sensitive to prior platinum based chemotherapy.