Recurrent ovarian cancer: Treatment with pegylated liposomal doxorubicin; a Westmead Cancer Care Centre experience
Recurrent ovarian cancer: Treatment with pegylated liposomal doxorubicin; a Westmead Cancer Care Centre experience
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DOI：
10.1111/j.1743-7563.2009.01263.x
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发表时间：
2010-03-01
影响因子：
1.9
通讯作者：
Harnett, Paul
中科院分区：
文献类型：
--
作者：
Dear, Rachel F.;Gao, Bo;Harnett, Paul
目的：描述的总生存期，无进展生存期，反应率和毒性的聚乙二醇脂质体阿霉素（PLD）在复发性卵巢cancer.Methods：回顾性研究45例复发或进展性卵巢癌进行了Westmead癌症护理中心。患者接受PLD治疗，起始剂量为30-50 mg/m2，每4 wheel.Results：共43例患者纳入分析。67%病例的起始剂量为40 mg/m2，21%病例的剂量增加。中位周期为2个（平均3个，范围1-7）。所有患者的反应都是可评估的，77%的患者由于疾病进展而停止治疗。根据CA-125标准评估的PLD总体应答率为14%（43例患者中有6例）。5名患者（12%）来自潜在铂敏感组，1名（2%）来自铂耐药组。总体中位无进展生存期为52天（2个月），铂类药物敏感组高于铂类药物耐药组（分别为4.4个月vs 1.7个月，P = 0.030）。中位总生存期为296天（10.6个月），铂敏感组的中位总生存期有长于铂耐药组的趋势（13 vs 9个月，P = 0.393）。总体而言，25%的患者有2级或3级toxics.Conclusion：PLD在铂类耐药的复发性卵巢癌中的益处很小，并且该治疗具有相当大的毒性。这些数据支持需要确定在这种情况下化疗是否对生活质量有任何有利的影响。澳大利亚新西兰妇科肿瘤组目前正在一项大型前瞻性研究中解决这个问题，该研究测量了姑息化疗在澳大利亚铂类耐药或难治性卵巢癌中的主观和客观获益（反应和生存率）。敦促临床医生将他们的患者纳入本研究，以解决这一重要问题。
Aim:To describe the overall survival, progression-free survival, response rate and toxicity of pegylated liposomal doxorubicin (PLD) in recurrent ovarian cancer.Methods:A retrospective study of 45 patients with recurrent or progressive ovarian cancer was conducted at the Westmead Cancer Care Centre. Patients received PLD at a starting dose of 30-50 mg/m2 every 4 weeks.Results:A total of 43 patients were included for analysis. The starting dose was 40 mg/m2 in 67% of cases, and 21 % had a dose increase. A median of 2 cycles (mean 3, range 1-7) was given. All patients were assessable for response and 77% stopped treatment due to progressive disease. The overall response rate to PLD assessed by CA-125 criteria was 14 percent (six of 43 patients). Five patients (12 percent) were from the potentially platinum-sensitive group and one (2 percent) was from the platinum-resistant group. The overall median progression-free survival was 52 days (2 months), which was greater in the platinum-sensitive than in the platinum-resistant group (4.4 months vs 1.7 months, respectively, P = 0.030). The median overall survival was 296 days (10.6 months) with a trend for this to be longer in the platinum-sensitive than in the platinum-resistant group (13 vs 9 months, P = 0.393). Overall 25 percent of patients had grade 2 or 3 toxicity.Conclusion:The benefit of PLD in platinum-resistant recurrent ovarian cancer is small and the treatment has considerable toxicity. These data support the need to establish whether chemotherapy in this setting has any favorable effect on quality of life. The Australian New Zealand Gynaecological Oncology Group is currently addressing this question in a large prospective study measuring both the subjective and objective benefit (response and survival) of palliative chemotherapy in platinum-resistant or refractory ovarian cancer in Australia. Clinicians are urged to enter their patients in this study to address this important question.