Efficacy and safety of dose-dense paclitaxel plus carboplatin as neoadjuvant chemotherapy for advanced ovarian, fallopian tube or peritoneal cancer
Efficacy and safety of dose-dense paclitaxel plus carboplatin as neoadjuvant chemotherapy for advanced ovarian, fallopian tube or peritoneal cancer
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剂量密集紫杉醇联合卡铂作为新辅助化疗治疗晚期卵巢癌、输卵管癌或腹膜癌的疗效和安全性
DOI：
10.1093/jjco/hyx118
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发表时间：
2017
影响因子：
2.4
通讯作者：
Aoki Daisuke
中科院分区：
文献类型：
--
作者：
Yoshihama Tomoko;Nomura Hiroyuki;Iwasa Naomi;Kataoka Fumio;Hashimoto Shiho;Nanki Yoshiko;Hirano Takuro;Makabe Takeshi;Sakai Kensuke;Yamagami Wataru;Hirasawa Akira;Aoki Daisuke
目的新辅助化疗(NAC)后的间歇性去卵巢手术(IDS)是目前治疗晚期卵巢癌、输卵管癌或腹膜癌的首选方法之一。本研究旨在评价剂量密集的紫杉醇联合卡铂方案(DDTC方案)作为NAC方案治疗卵巢癌、输卵管癌和腹膜癌的临床疗效和安全性。DDTC治疗方案为紫杉醇80 mg/m2静脉滴注第1、8、15天，卡铂6.0 mg/ml×min静脉滴注第1天，每3周1次。结果以DDTC治疗为NAC的有效率为92%，无一例发生疾病进展。8%的患者出现4级血液学毒性和≥3级非血液学毒性，但无患者因不良事件而停用NAC。介入治疗完全手术率为%，最佳手术率为96%。16%的患者出现≥3级围手术期并发症，但无围手术期死亡。中位总生存期为35.7个月，中位无进展生存期为17.7个月。完全手术率高，围手术期并发症可接受。
ObjectiveInterval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) is currently one of the preferred treatment options for advanced ovarian, fallopian tube or peritoneal cancer. This study was conducted to evaluate the clinical efficacy and safety of dose-dense paclitaxel plus carboplatin therapy (ddTC therapy) as NAC for these cancers.Patients and methodsA retrospective study was conducted in 25 patients with Stage III/IV ovarian, fallopian tube or peritoneal cancer who received ddTC therapy as NAC. For ddTC therapy, paclitaxel (80 mg/m2) was administered intravenously on Days 1, 8 and 15 and carboplatin (AUC 6.0 mg/ml × min) was administered intravenously on Day 1 every 3 weeks. IDS was performed after three cycles of ddTC therapy, and ddTC therapy was also continued after surgery.ResultsWith ddTC therapy as NAC, the response rate was 92% and disease progression did not occur in any patient. Grade 4 hematologic toxicity and ≥Grade 3 non-hematologic toxicity both occurred in 8% of the patients, but no patient discontinued NAC because of adverse events. When IDS was performed, the complete surgery rate was 64% and the optimal surgery rate was 96%. ≥Grade 3 perioperative complications occurred in 16% of the patients, but there were no perioperative deaths. Median overall survival was 35.7 months and median progression-free survival was 17.7 months.ConclusionThis study showed that ddTC therapy was considerably effective and tolerable as NAC. The complete surgery rate was high with IDS, and perioperative complications were acceptable.