Review of dose-intense platinum and/or paclitaxel containing chemotherapy in advanced and recurrent epithelial ovarian cancer.
Review of dose-intense platinum and/or paclitaxel containing chemotherapy in advanced and recurrent epithelial ovarian cancer.
复制标题
回顾晚期和复发性上皮性卵巢癌的剂量密集型铂和/或紫杉醇化疗。
DOI：
10.2174/138161212802002634
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发表时间：
2012
影响因子：
3.1
通讯作者：
M. van der Burg
中科院分区：
文献类型：
--
作者：
I. Boere;M. van der Burg
卵巢癌是西方世界女性中最致命的妇科癌症，5年生存率为49.7%。晚期卵巢癌可以手术和化疗治疗，但尽管最初的反应率高达60- 75%，但许多女性会出现疾病复发，预后不良，FIGO IIIc期和IV期疾病的5年总生存率仅为32%和18%。为了改善原发性和复发性疾病的结果，已经研究了剂量密集和剂量密集化疗方案。本综述总结了一线和二线治疗的这些结果。在一线治疗中，大多数研究中未发现剂量密集方案的获益，仅毒性增加。然而，结果与最近的日本妇科肿瘤组（JGOG）试验相矛盾，该试验显示，每周一次剂量密集的紫杉醇联合标准的每周3次卡铂治疗的患者的无进展生存期和总生存期有所改善。对于复发性疾病，每周剂量密集联合化疗似乎对铂类耐药卵巢癌患者非常有效。几项II期研究显示，与非铂类化疗相比，剂量密集型紫杉醇和卡铂的缓解率、无进展生存期和总生存期增加。相反，在铂敏感性卵巢癌中，每周紫杉醇和卡铂的结果似乎与标准的3周方案相当。
Ovarian cancer is the most lethal gynecological cancer in women in the western world with a 5-year survival of 49.7%. Advanced stage ovarian cancer is treated both surgically and with chemotherapy, but despite initial high response rates of 60- 75%, many women experience disease recurrence with a dismal prognosis, 5 year overall survival for FIGO stage IIIc and IV disease being only 32 and 18%. In an attempt to improve outcome for both primary and recurrent disease, dose-intense and dose-dense chemotherapy regimens have been investigated. This overview summarizes these results in first and second-line treatment. In first-line treatment, no benefit was found of dose-intense regimes in the majority of the studies, only toxicity was increased. However, results are conflicting with the recent Japanese Gynecologic Oncology Group (JGOG) trial showing an improved progression free and overall survival in patients treated with dose-dense weekly paclitaxel combined with standard 3-weekly carboplatin. For recurrent disease dose-dense weekly combination chemotherapy seems to be very effective in patients with platinum-resistant ovarian cancer. Several phase II studies showed an increase in response rate, progression free survival and overall survival for dose-dense paclitaxel and carboplatin, compared to results of nonplatinum chemotherapy. In platinum-sensitive ovarian cancer, on contrary, the results of weekly paclitaxel and carboplatin seem to be comparable with standard 3-weekly regimens.