재발성 상피성 난소암 환자에서 Gemcitabine 단독 항암화학요법을 사용한 4예
Gemcitabine as second-line chemotherapy in patients with recurrentepithelial ovarian cancer: Review of four cases
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광범위 수술 후 platinum과 paclitaxel의 항암화학요법은 상피성 난소암 환자의 생존율을 향상시켰다. 그러나 적절한 종양감축술과 platinum을 기본으로 하는 다제병용 화학요법에도 불구하고 진행성 병변을 가진 환자의 대부분에서 종양의 재발과 진행을 경험하며, 보다 효과적인 이차 항암화학요법의 필요성이 대두되었다. 인제대학교 상계백병원에서 진단 및 일차치료 후 재발한 네 명의 진행성 상피성 난소암 환자들이 gemcitabine을 투여 받았으며, gemcitabine은 체표면적 (m2)당 1000 mg을 30분에 걸쳐 정주하였으며, 3주간 매주 1차례 (1일째, 8일째, 15일째) 정주하고 4주째 쉬는 것을 1주기로 하여 28일마다 반복하여 투약하였다. 한 명의 환자는 완전관해를 보이고 다른 한 명의 환자는 안정성 병변의 소견을 보인 반면 두 명의 환자에서는 진행성 병변의 소견을 보였으며, 이들 중 한 명은 치료 2개월 뒤 사망하였다. Grade 3의 백혈구 감소증은 과립구 형성 자극인자 (G-CSF)의 투여로 치료되었으며, 이전의 항암화학요법으로 소실된 머리카락은 네 명 모두에서 회복되었다. 저자 등은 paclitaxel과 cisplatin의 항암화학요법 후 재발한 난소암 환자에서 gemcitabine 단독 항암화학요법을 시행한 4예를 보고하는 바이다.
Abstract
Adjuvant multiagent chemotherapy with platinum and paclitaxel after optimal cytoreductive surgery decisively improved survival rates of patients with epithelial ovarian carcinoma. However, more than two- thirds of patients with advanced disease will encounter tumor progression, underlining the need for effective second-line strategies. Continued efforts to discover new active agents for the treatment of patients with ovarian carcinoma had identified gemcitabine. Four patients with epithelial ovarian carcinoma, who were treated in Inje University Sanggye Paik Hospital and recurred thereafter received gemcitabine 1,000 mg/m2 as a 30 min intravenous infusion on days 1, 8, and 15, which was repeated every 28 days. The disease progressed in two patients, while one showed stable disease and another reached complete response. One patient expired of disease two months after the completion of therapy. Grade 3 leukopenia was successfully managed using G-CSF. Regrowth of hair lost during previous chemotherapy occurred in all subjects. We report four cases of advanced recurrent ovarian carcinoma which were treated with gemcitabine.
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