Extending the platinum-free interval with a non-platinum therapy in platinum-sensitive recurrent ovarian cancer - Results from the SOCRATES retrospective study
Extending the platinum-free interval with a non-platinum therapy in platinum-sensitive recurrent ovarian cancer - Results from the SOCRATES retrospective study
复制标题
DOI：
10.1159/000108592
复制
发表时间：
2006-01-01
期刊：
影响因子：
3.5
通讯作者：
Favalli, Giuseppe
中科院分区：
文献类型：
--
作者：
Pignata, Sandro;Ferrandina, Gabriella;Favalli, Giuseppe
背景：有人提出，通过非铂类干预治疗延长无铂治疗间隔可提高铂类敏感性复发性卵巢癌后期铂类再治疗的疗效。该假设基于小系列数据，尽管尚未得到前瞻性验证，但该策略近年来已在意大利得到普遍实践。 SOCRATES 研究回顾性评估了 2000 年至 2002 年在意大利 37 个中心观察到的一组复发性铂敏感卵巢癌患者的护理模式。数据收集于 2005 年 4 月至 9 月期间。方法：无铂治疗间隔 1-6 个月的复发性卵巢癌患者符合资格。收集了 493 名患者档案，其中 428 名患者符合资格并进行了分析。结果：第1线结束至复发间隔6～12个月164例（39.5%），1～12个月251例（60.5%）。患者接受了第二（100%）、第三（80.1%）、第四（50.2%）、第五（28.3%）和第六（11.9%）线化疗。在第二线，282 例（65.9%）接受铂类化疗（A 组），而 146 例（34.1%）接受非铂类化疗（B 组）。在后一组中，67 名患者在进展后期接受了铂类治疗（B1 组），而 79 名患者从未接受过铂类治疗（B2 组）。 A 组和 B1 组患者接受铂类再治疗的中位时间分别为 20 个月和 23.1 个月。 A 组和 B1 组对首次接受铂治疗的反应率分别为 74.4% 和 57.4% (p = 0.02)。 B2 组的特点是反应率和生存率最差。在第一次铂类再治疗的多变量分析时间（第 2 线与后来的线比较；p = 0.0132；OR = 2.34）和年龄（p = 0.0029；OR = 2.41）与铂类治疗的较高反应可能性独立相关。结论：由于回顾性研究的局限性，我们的数据对以下假设提出质疑：对于复发性铂类敏感卵巢癌患者，通过干预性非铂类治疗延长无铂间隔可提高进一步铂类再治疗的缓解率。版权所有 (C) 2006 S. Karger AG，巴塞尔。
Background: It has been proposed that extending the platinum-free interval with intervening non- platinum therapy increases the efficacy of a later re- treatment with platinum in platinum- sensitive recurrent ovarian cancer. This hypothesis is based on data from small series and although it has not been validated prospectively, this strategy has entered general practice in Italy in the last years. The SOCRATES study retrospectively assessed the pattern of care of a cohort of patients with recurrent platinum- sensitive ovarian cancer observed in the years 2000 - 2002 in 37 Italian centres. Data were collected between April and September 2005. Methods: Patients with recurrent ovarian cancer with a platinum- free interval 1 6 months were eligible. 493 patient files were collected and 428 were eligible and analyzed. Results: The interval from the end of the 1st line to relapse was 6 - 12 months in 164 patients ( 39.5%) and 1 12 months in 251 cases ( 60.5%). Patients received a 2nd ( 100%), 3rd ( 80.1%), 4th ( 50.2%), 5th ( 28.3%), and 6th ( 11.9%) line of chemotherapy. At 2nd line 282 ( 65.9%) received platinum ( group A), while 146 ( 34.1%) received non- platinum chemotherapy ( group B). In the latter group, 67 patients received platinum at later progression ( group B1), while 79 never received platinum ( group B2). Median time to platinum re- treatment was 20 and 23.1 months in patients of groups A and B1, respectively. The response rate to the first platinum received was 74.4 and 57.4% in groups A and B1, respectively ( p = 0.02). Group B2 was characterized by the worst response rate and survival. At multivariate analysis time of first platinum re- treatment ( 2nd line vs. later; p = 0.0132; OR = 2.34) and age ( p = 0.0029; OR = 2.41) was independently associated with a higher possibility of response to platinum. Conclusions: With the limits of a retrospective study, our data question the hypothesis that extending the platinum- free interval with an intervening non- platinum therapy in patients with recurrent platinum-sensitive ovarian cancer improves the response rate of a further platinum re- treatment. Copyright (C) 2006 S. Karger AG, Basel.