The potential benefit of 6 vs. 3 cycles of chemotherapy in subsets of women with early-stage high-risk epithelial ovarian cancer: An exploratory analysis of a Gynecologic Oncology Group study
The potential benefit of 6 vs. 3 cycles of chemotherapy in subsets of women with early-stage high-risk epithelial ovarian cancer: An exploratory analysis of a Gynecologic Oncology Group study
复制标题
DOI：
10.1016/j.ygyno.2009.10.073
复制
发表时间：
2010-03-01
影响因子：
4.7
通讯作者：
Bell, Jeffrey
中科院分区：
文献类型：
--
作者：
Chan, John K.;Tian, Chunqiao;Bell, Jeffrey
目标.先前的一项早期高危卵巢癌临床试验显示，接受六个周期化疗的患者复发率低于接受三个周期化疗的患者。我们建议确定亚组的患者谁可能受益于更多的化疗周期。根据临床病理因素分析接受6个周期与3个周期化疗的患者的结果。结果427例患者（中位年龄55岁）中，Ⅰ期占69%，透明细胞型占30%，类浆液性占25%，浆液性占23%，粘液性占7%，其他细胞型占15%。接受6个周期和3个周期化疗的患者复发风险在年龄、体能状态、分期、疾病分级、腹水、肿瘤破裂或阳性细胞学检查方面没有差异。然而，与非浆液性肿瘤（HR = 0.94，CI 0.60-1.49）相比，浆液性肿瘤患者在6个周期的化疗后的复发风险显著低于3个周期的化疗（HR = 0.33，CI = 0.14-0.77：p=0.04）。然而，同质性检验未显示不同细胞类型的治疗效果存在差异（p = 0.285）。在浆液性肿瘤患者中，接受6个周期化疗的患者5年无复发生存率为83%，接受3个周期化疗的患者5年无复发生存率为60%（p = 0.007）。在对早期高危卵巢癌的探索性分析中，我们的数据表明，六个周期而不是三个周期的化疗可能会降低浆液性肿瘤患者的复发率。需要进一步的研究来证实这些发现。(C)2009 Elsevier Inc. All rights reserved.
Objectives. A prior clinical trial oil early-stage high risk ovarian cancer showed a lower recurrence rate In those treated with six vs. three cycles of chemotherapy. We proposed to identify Subsets of patients who may benefit from more cycles of chemotherapy.Methods. outcomes of patients who underwent six vs. three cycles of chemotherapy were analyzed based on clinico-pathologic factors. Kaplan-Meier estimates and Cox Regression Model Were used for analyses.Results, Of 427 patients (median age: 55 years), 69% had stage I disease, 30% had clear cell, 25% endometrioid, 23% serous, 7% mucinous, and 15% had other cell types. The risk of recurrence in those who had six vs. three cycles of chemotherapy was not different based on age, performance status, stage, grade of disease, presence of ascites, tumor rupture, or positive cytology. However, those with serous tumors had a significantly lower risk of recurrence after six vs. three cycles of chemotherapy (HR = 0.33, CI = 0.14-0.77: p=0.04) in Contrast to non-serous tumors (HR = 0.94, CI 0.60-1.49). Nevertheless, a test of homogeneity did not show a difference in treatment effects across cell types (p = 0.285). Of those with serous tumors, the 5-year recurrence-free Survival was 83% and 60% in those who received six vs. three cycles of chemotherapy, respectively (p = 0.007).Conclusions. In this exploratory analysis of early-stage high risk ovarian Cancer, Our data Suggest that six rather than three cycles of chemotherapy may decrease the recurrence of patients with serous tumors. Further Studies are needed to confirm these findings. (C) 2009 Elsevier Inc. All rights reserved.