RESPONSE TO 2ND-LINE WEEKLY CISPLATIN CHEMOTHERAPY IN OVARIAN-CANCER PREVIOUSLY TREATED WITH A CISPLATIN-BASED OR CARBOPLATIN-BASED REGIMEN
RESPONSE TO 2ND-LINE WEEKLY CISPLATIN CHEMOTHERAPY IN OVARIAN-CANCER PREVIOUSLY TREATED WITH A CISPLATIN-BASED OR CARBOPLATIN-BASED REGIMEN
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DOI：
10.1016/0959-8049(94)e0125-n
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发表时间：
1994-01-01
影响因子：
8.4
通讯作者：
PARAZZINI, F
中科院分区：
文献类型：
--
作者：
BOLIS, G;SCARFONE, G;PARAZZINI, F
在1984年至1991年期间观察的一项临床系列研究中，分析了以前用顺铂或卡铂为基础的方案治疗的卵巢癌患者对二线每周顺铂化疗的反应。在一线顺铂或卡铂方案治疗后达到病理学完全缓解或病理学最佳部分缓解的女性在一线治疗后至少4个月复发或进展时接受二线化疗。共有72名女性被纳入分析。二线化疗方案为：顺铂1 mg/kg，每周1次，共7个疗程;每3周一次，共3个疗程（28例受试者）;顺铂1 mg/kg+依托泊苷90 mg/m2，静脉注射，每周一次，共7个疗程（11例受试者）;顺铂1 mg/kg，每周一次，共9个疗程;卡铂250 mg/m2，每3周一次，共3个疗程（33例受试者）。在72名女性中，22名（31%，14名临床，8名病理）完全缓解，28名（39%）部分缓解（24名临床，4名病理）。完全缓解组24个月累积生存率为63%，部分缓解组为32%，无缓解组22例均在诊断复发后24个月内死亡（logrank检验P < 0.05）。完全缓解和部分缓解的频率随着首次诊断和复发之间的间隔而增加：在33名首次诊断后复发< 18个月的妇女中，20名（61%）受试者获得完全反应或部分反应，这一数字为67%，（21名女性中有14名）在首次诊断后18至< 36个月内复发的受试者中，89%（16/18）复发≥ 36个月者。与首次诊断后4-< 18个月复发的女性相比，复发时间在18至< 36个月之间的女性的缓解OR为1.3（95%CI 0.4-4.1），复发时间大于或等于36个月的女性的缓解OR为5.2（95%CI 1.1-24.3）手术（chi（1）（2）趋势p < 0.05）。术后4 ~< 18个月、18 ~< 36个月、36个月以上复发者二线化疗结束后生存率分别为24、20、67%（logrank检验，P < 0.05）。首次诊断时的年龄、首次诊断时的组织学、分期和疾病分级以及复发部位与二线治疗的反应无关。
Response to a second-line weekly cisplatin chemotherapy in ovarian cancer previously treated with cisplatin- or carboplatin-based regimens was analysed in a clinical series observed between 1984 and 1991. Women who achieved pathological complete response or pathological optimal partial remission after first-line cisplatin- or carboplatin-based regimens were treated at recurrence or progression, occurring at least 4 months after first-line treatment, with second-line chemotherapy. A total of 72 women were included in the analysis. Second-line chemotherapy regimens were: cisplatin 1 mg/kg weekly for seven courses plus epirubicin 70 mg/m(2) intravenously (i.v.) every 3 weeks for three courses (28 subjects), cisplatin 1 mg/kg plus etoposide 90 mg/m(2) i.v. weekly for a total of seven courses (11 subjects) and cisplatin 1 mg/kg weekly for nine courses plus carboplatin 250 mg/m(2) every 3 weeks for three courses (33 subjects). Of the 72 women, 22 (31%, 14 clinical, 8 pathological) had a complete response and 28 (39%), a partial response (24 clinical, 4 pathological). The 24-month cumulative survival probability was 63% in women with complete response, 32% in those who had partial response, but all the 22 nonresponders died within 24 months from diagnosis of recurrence (log rank test P < 0.05). The frequency of complete response and partial response increased with the interval between first diagnosis and recurrence: among the 33 women who had recurrent disease to < 18 months from first diagnosis, complete response or partial response was obtained in 20 (61%) subjects, this figure was 67% (14 out of 21 women) among subjects who had recurrent disease between 18 and < 36 months from first diagnosis and 89% (16/18) among those who had recurrence greater than or equal to 36 months. In comparison with women who had recurrence 4-< 18 months from first diagnosis, the OR of response was 1.3 (95% CI 0.4-4.1) for those who had recurrence between 18 and < 36 and 5.2 (95% CI 1.1-24.3) for those who had recurrence greater than or equal to 36 months from surgery (chi(1)(2) trend p < 0.05). Survival rate after the end of second line chemotherapy for women who relapsed 4-< 18 months, 18-< 36 or 36 months or more after surgery were, respectively, 24, 20 and 67% (log rank test, P < 0.05). Age at first diagnosis, histology, stage, and grading of the disease at first diagnosis and site of recurrence were not associated with response to second-line therapy.