Intraperitoneal treatment and dose-intense therapy in ovarian cancer
Intraperitoneal treatment and dose-intense therapy in ovarian cancer
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DOI：
10.1023/a:1008363519331
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发表时间：
1999-01-01
影响因子：
50.5
通讯作者：
Grenman, S
中科院分区：
文献类型：
--
作者：
Ozols, RF;Gore, M;Grenman, S
背景：关于大剂量化疗在晚期卵巢癌患者中的作用一直存在争议。基于回顾性研究，已经表明，当铂化合物的剂量特别增加时，结果将得到改善。高剂量的治疗可以使用腹膜内给药途径或与血液支持的形式自体骨髓移植（ABMT）或外周血干细胞transfusions（PBSCT）。方法：经验丰富的临床研究人员审查了已发表的数据，可在高剂量化疗和腹膜内给药。此外，正在进行的ABMT或PBSCT的临床试验也reviewed.Results：前瞻性随机试验未能证明，铂类化合物的剂量增加一倍，增加晚期卵巢癌患者的生存率。顺铂或紫杉醇腹腔化疗仍是一个研究领域，在既往未治疗患者中进行的前瞻性随机试验以及在达到完全缓解的患者中进行的部分巩固治疗正在进行中。在既往接受过治疗的晚期卵巢癌患者中进行的ABMT或PBSCT高剂量化疗的II期试验产生了比常规剂量更高的反应率，尽管尚未证明对生存率有影响。在既往未经治疗的患者中进行的前瞻性随机试验正在进行中。在这些试验完成之前，ABMT或PBSCT的大剂量化疗和腹腔化疗应被视为研究性的。
Background: There has been a longstanding controversy regarding the role of high-dose chemotherapy in patients with advanced ovarian cancer. Based on retrospective studies, it has been suggested that there will be improved results when doses of platinum compounds in particular are increased. High-dose therapy can be administered using an intraperitoneal route of drug delivery or with haematologic support in the form of autologous bone marrow transplantation (ABMT) or peripheral blood stem cell transfusions (PBSCT).Methods: Experienced clinical investigators reviewed published data available on high-dose chemotherapy and intraperitoneal drug delivery. In addition, ongoing clinical trials of ABMT or PBSCT were also reviewed.Results: Prospective randomised trials have failed to demonstrate that doubling the dose of platinum compounds increases survival in patients with advanced ovarian cancer. Intraperitoneal chemotherapy with cisplatin or paclitaxel remains an area of investigation and prospective randomised trials in previously untreated patients as well as part of consolidation therapy in patients achieving a complete remission are in progress. Phase II trials of high-dose chemotherapy with ABMT or PBSCT in previously treated patients with advanced ovarian cancer have produced higher response rates than achieved with conventional doses although there has been no proven impact upon survival. Prospective randomised trials in previously untreated patients are in progress. Until the completion of these trials, high-dose chemotherapy with ABMT or PBSCT and intraperitoneal chemotherapy should be considered investigational.