The role of neoadjuvant chemotherapy in the management of patients with advanced stage ovarian cancer: Survey results from members of the Society of Gynecologic Oncologists
The role of neoadjuvant chemotherapy in the management of patients with advanced stage ovarian cancer: Survey results from members of the Society of Gynecologic Oncologists
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DOI：
10.1016/j.ygyno.2010.06.021
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发表时间：
2010-10-01
影响因子：
4.7
通讯作者：
Zighelboim, Israel
中科院分区：
文献类型：
--
作者：
Dewdney, Summer B.;Rimel, B. J.;Zighelboim, Israel
Objective.最近的随机对照数据表明，新辅助化疗（NACT）与间隔减积（ID）可能产生类似的总生存期和无进展生存期相比，标准的原发性细胞减灭术后化疗。本研究的目的是评估妇科肿瘤学家协会（SGO）成员目前的护理模式，特别是整理他们的意见和使用NACT治疗晚期卵巢癌。一个20个项目的调查问卷发送到所有的SGO成员（n = 1137）的工作电子邮件地址。数据收集和分析使用描述性统计与市售的在线调查软件。独立性的卡方检验用于确定组间反应的差异。在339名（30%）回应成员中，大多数很少使用NACT，60%的受访者在不到10%的晚期卵巢癌病例中使用NACT。受访者认为现有证据不足以证明NACT其次是ID（82%），大多数人也不认为应该首选（74%）。62%的受访者认为术前不可能准确预测是否可能进行最佳细胞减灭术。39%的人认为，与原发性减瘤相比，术前影像学检查显示有巨大上腹部疾病的妇女将受益于NACT。如果在ID时发现严重疾病，43%的人会继续接受IV化疗，42%的人会在最佳细胞减少的情况下放置IP端口。当ID显示显微镜下病变时，51%的患者将继续IV治疗，其余患者将继续IP治疗。86%的受访者认为生物学和手术因素决定了患者的预后。大多数响应SGO成员不治疗患者NACT后ID。目前可用的NACT/ID的研究已经不足以说服大多数妇科肿瘤学家将其纳入实践。我们的研究结果提供了一个基准，进一步的研究可以评估NACT/ID渗透到临床实践。(C)2010年爱思唯尔公司All rights reserved.
Objective. Recent randomized controlled data suggest that neoadjuvant chemotherapy (NACT) with interval debulking (ID) may produce similar overall survival and progression free survival compared to standard primary cytoreduction followed by chemotherapy. The object of our study was to assess current patterns of care among members of the Society of Gynecologic Oncologists (SGO), specifically collating their opinions on and use of NACT for advanced stage ovarian cancer.Methods. A 20-item questionnaire was sent to all working e-mail addresses of SGO members (n = 1137). The data was collected and analyzed using descriptive statistics with commercially available online survey software. The Chi-square test for independence was used to determine differences in responses between groups.Results. Of 339 (30%) responding members, most rarely employ NACT, with 60% of respondents using NACT in less than 10% of advanced stage ovarian cancer cases. Respondents did not consider available evidence sufficient to justify NACT followed by ID (82%), nor did most think it should be preferred (74%). Sixty-two percent of respondents thought it was impossible to accurately predict preoperatively whether an optimal cytoreduction is possible. Thirty-nine percent believed that women with bulky upper abdominal disease on preoperative imaging would benefit from NACT versus primary debulking. If gross disease were found at ID, 43% would continue to treat with IV chemotherapy, and 42% would place an IP port if optimally cytoreduced. When ID reveals microscopic disease, 51% would continue IV treatment and the remaining IP therapy. Eighty-six percent of the respondents believed that both biological and surgical factors determine patient outcomes.Conclusions. The majority of responding SGO members do not treat patients with NACT followed by ID. Currently available studies of NACT/ID have been insufficient to convince most gynecologic oncologists to incorporate it into practice. Our results provide a benchmark against which further research can assess the penetration of NACT/ID into clinical practice. (C) 2010 Elsevier Inc. All rights reserved.