Retrospective analysis of carboplatin and paclitaxel as initial second-line therapy for recurrent epithelial ovarian carcinoma: Application toward a dynamic disease state model of ovarian cancer
Retrospective analysis of carboplatin and paclitaxel as initial second-line therapy for recurrent epithelial ovarian carcinoma: Application toward a dynamic disease state model of ovarian cancer
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DOI：
10.1200/jco.20.5.1238
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发表时间：
2002-03-01
影响因子：
45.3
通讯作者：
Spriggs, DR
中科院分区：
文献类型：
--
作者：
Dizon, DS;Hensley, ML;Spriggs, DR
目的：大多数上皮性卵巢癌（EOC）患者在一线化疗后获得完全缓解，但会出现疾病复发。卡铂和紫杉醇用于铂敏感性复发性疾病患者，尽管关于用这种策略治疗的复发性疾病患者的反应和生存率的信息很少。我们试图确定首次复发时接受卡铂和紫杉醇治疗的EOC患者的结局。此外，我们试图定义一个新的范式，疾病的转变与EOC.Patients和方法：89例患者被确定谁有一个完整的反应，以铂为基础的一线化疗EOC，复发后6个月完成一线化疗，并与卡铂和紫杉醇作为二线治疗。84例病例可用于生存终点分析，66例可用于评估缓解情况。中位随访时间为27个月。总有效率为70%。队列的中位无进展间隔为13个月（95%置信区间[Cl]，10.7至13.8个月）。3年生存率为72%（95%CI，59.4 - 86.1%）。毒性有限，未观察到给药导致的死亡。使用这些数据，它是可能的，以构建一个疾病状态模型的EOC，它提供了风险估计临床上不同的categors.Conclusion之间的过渡：再治疗卡铂和紫杉醇是有效的初始治疗复发性EOC。这应该成为随机试验的基础，以确定潜在铂敏感患者EOC复发的初始治疗的最佳药物。(C)2002年，美国临床肿瘤学会。
Purpose : The majority of patients with epithelial ovarian cancer (EOC) who achieve a complete remission with front-line chemotherapy develop recurrent disease. Carboplatin and paclitaxel are used for patients with platinum-sensitive recurrent disease, although there is little information regarding the response and survival in unselected patients treated with this strategy. We sought to determine the outcomes for patients with EOC treated with carboplatin and paclitaxel at the time of first recurrence. in addition, we sought to define a new paradigm for disease transition in patients with EOC.Patients and Methods: Eighty-nine patients were identified who had a complete response to front-line platinum-based chemotherapy for EOC, relapsed 6 months after completion of front-line chemotherapy, and were treated with carboplatin and paclitaxel as second-line therapy.Results: Eighty-four cases were available for analysis of survival end points, and 66 were assessable for response. The median follow-up was 27 months. The overall response rate was 70%. The median progression-free interval for the cohort was 13 months (95% confidence interval [Cl], 10.7 to 13.8 months). The 3-year survival rate was 72% (95% Cl, 59.4 to 86.1%). Toxicity was limited, and no deaths from treatment were observed. Using this data, it is possible to construct a disease states model of EOC, which provides risk estimates for transitions between clinically distinct categories.Conclusion: Re-treatment with carboplatin and paclitaxel is effective as initial therapy in recurrent EOC. This should form the basis of a randomized trial to determine the best agents for initial treatment of relapse from EOC in potentially platinum-sensitive patients. (C) 2002 by American Society of Clinical Oncology.