A meta-analysis of the efficacy of intraperitoneal cisplatin for the front-line treatment of ovarian cancer
A meta-analysis of the efficacy of intraperitoneal cisplatin for the front-line treatment of ovarian cancer
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DOI：
10.1111/j.1525-1438.2006.00846.x
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发表时间：
2007-05-01
影响因子：
4.8
通讯作者：
Alberts, D. S.
中科院分区：
文献类型：
--
作者：
Hess, L. M.;Benham-Hutchins, M.;Alberts, D. S.
卵巢癌是美国女性癌症死亡的第四大原因。为卵巢癌患者提供的一线化疗通常包括静脉注射 (IV) 铂加紫杉烷方案，并且在过去 10 年中几乎没有变化。美国最近完成的许多 III 期随机试验报告称，腹腔 (IP) 给予顺铂可改善无进展生存期 (PFS) 和/或总生存期 (OS)。本研究的目的是汇集已发表的数据，对 IP 顺铂在卵巢癌患者初始化疗中的随机试验进行荟萃分析。发起这项研究的目的是为了更有效地估计 IP 治疗对这些患者的治疗影响。启动了一项检索策略，检索 1990 年 1 月至 2006 年 1 月期间从多个来源发表的 IP 顺铂治疗随机试验的结果。确定了 1716 名卵巢癌患者的六项随机试验并将其纳入本次分析。与静脉注射治疗方案相比，IP 顺铂的 PFS 汇总风险比 (HR) 为 0.792（95% CI：0.688-0.912，P = 0.001），OS 的汇总 HR 为 0.799（95% CI：0.702-0.910，P = 0.0007）。这些发现强烈支持在III期、最佳减瘤卵巢癌的一线治疗中加入IP顺铂方案来提高生存率。
Ovarian cancer is the fourth leading cause of cancer death among women in the United States. First-line chemotherapy offered to patients with ovarian cancer generally consists of an intravenous (IV) platinum plus taxane regimen and has remained virtually unchanged for the past 10 years. A number of recently completed phase III randomized trials in the United States have reported improved progression-free survival (PFS) and/or overall survival (OS) with the intraperitoneal (IP) administration of cisplatin. The purpose of this study was to pool the published data to perform a meta-analysis of randomized trials of IP cisplatin in the initial chemotherapy treatment of ovarian cancer patients. This study was initiated to obtain a more valid estimate of the therapeutic impact of IP treatment for these patients. A search strategy was initiated that searched published findings of randomized trials of IP cisplatin therapy from multiple sources from January 1990 through January 2006. Six randomized trials of 1716 ovarian cancer patients were identified and included in this analysis. The pooled hazard ratio (HR) for PFS of IP cisplatin as compared to IV treatment regimens is 0.792 (95% CI: 0.688-0.912, P = 0.001), and the pooled HR for OS is 0.799 (95% CI: 0.702-0.910, P = 0.0007). These findings strongly support the incorporation of an IP cisplatin regimen to improve survival in the front-line treatment of stage III, optimally debulked ovarian cancer.