Improved Survival Trends in Platinum-Resistant Patients with Advanced Ovarian, Fallopian or Peritoneal Cancer Treated with First-Line Paclitaxel/Platinum Chemotherapy: The Impact of Novel Agents
Improved Survival Trends in Platinum-Resistant Patients with Advanced Ovarian, Fallopian or Peritoneal Cancer Treated with First-Line Paclitaxel/Platinum Chemotherapy: The Impact of Novel Agents
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DOI：
10.1159/000341366
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发表时间：
2013-01-01
期刊：
影响因子：
3.5
通讯作者：
Dimopoulos, Meletios-Athanasios
中科院分区：
文献类型：
--
作者：
Bamias, Aristotle;Bamia, Christine;Dimopoulos, Meletios-Athanasios
目的：铂耐药晚期卵巢癌患者预后较差。在过去十年中，批准的药物对生存的影响尚未得到澄清。我们研究了过去15年铂耐药患者接受细胞减少手术后紫杉醇/铂化疗的生存趋势。方法：纳入一线紫杉醇/铂化疗后的卵巢、输卵管或腹膜上皮性癌、III/IV期和铂耐药患者。根据化疗时间进行分组：A组（1995年3月31日~ 2001年12月31日）56例；B组（2002年1月1日~ 2008年12月24日）57例。为了弥补两组之间随访的差异，我们进行了最小随访（MFU）分析，仅考虑在随访3年内发生事件的女性。3年内没有发病的患者在当时被审查。结果：MFU分析显示，B组的中位总生存期（OS）明显更长：12.3个月比17.5个月（p = 0.012）。这是由于复发后中位OS增加了一倍：5.7个月vs 10.9个月（p = 0.0180）。多因素Cox回归显示，组和组织学是与OS有统计学显著相关的因素。复发后，B组患者以多柔比星和吉西他滨脂质体为主，A组患者以铂类化合物、多西他赛和口服依托泊苷为主（p < 0.001）。结论：无铂或紫杉烷交叉耐药的新型药物的引入改善了铂耐药患者的预后。巴塞尔S. Karger股份有限公司版权所有
Objective: The prognosis for patients with platinum-resistant advanced ovarian cancer remains poor. The impact of approved agents on survival has not been clarified during the last decade. We studied survival trends during the last 15 years in platinum-resistant patients treated with cytoreductive surgery followed by paclitaxel/platinum chemotherapy. Methods: Patients with epithelial ovarian, fallopian or peritoneal cancer, stages III/IV and platinum-resistant disease after first-line chemotherapy with paclitaxel/platinum were included. They were grouped according to the period of chemotherapy: group A 31/3/1995-31/12/2001 (n = 56) and Group B 1/1/2002-24/12/2008 (n = 57). In order to compensate for the difference in follow-up between the 2 groups, we performed minimum follow-up (MFU) analyses by considering as cases only women who had an event within 3 years of follow-up. Patients with no events for up to 3 years were censored at that time. Results: MFU analyses showed that median overall survival (OS) was significantly longer in group B: 12.3 vs. 17.5 months (p = 0.012). This was due to a doubling of the median OS after relapse: 5.7 vs. 10.9 months (p = 0.0180). Multivariate Cox regression indicated group and histology as factors statistically significantly associated with OS. Following relapse, patients in group B were predominantly treated with liposomal doxorubicin and gemcitabine, and patients in group A were treated with platinum compounds, docetaxel and oral etoposide (p < 0.001). Conclusions: The introduction of novel agents without cross-resistance to platinum or taxanes has improved the prognosis of platinum-resistant patients. copyright (C) 2012 S. Karger AG, Basel