Prognostic impact of adding bevacizumab to carboplatin and paclitaxel for recurrent, persistent, or metastatic cervical cancer
Prognostic impact of adding bevacizumab to carboplatin and paclitaxel for recurrent, persistent, or metastatic cervical cancer
复制标题
卡铂和紫杉醇中添加贝伐珠单抗对复发性、持续性或转移性宫颈癌的预后影响
DOI：
10.1016/j.tjog.2022.06.005
复制
发表时间：
2022
影响因子：
2.1
通讯作者：
Kato Kiyoko
中科院分区：
文献类型：
--
作者：
Yasunaga Masafumi;Yahata Hideaki;Okugawa Kaoru;Shimokawa Mototsugu;Maeda Yumiko;Hori Emiko;Kodama Keisuke;Yagi Hiroshi;Ohgami Tatsuhiro;Onoyama Ichiro;Asanoma Kazuo;Kato Kiyoko
最近的随机III期试验显示，在常规化疗基础上加用贝伐单抗对晚期宫颈癌患者的总生存期（OS）有显著益处。本研究的目的是评估日本复发性，持续性或转移性宫颈癌患者的预后影响，其中贝伐单抗加入紫杉醇加carboplatin.Materials and MethodsA回顾性分析了90例复发性，持续性或转移性宫颈癌患者，主要治疗紫杉醇加carboplatin之间2005年和2019年在我院。分析了以下临床病理学变量的数据：（1）贝伐珠单抗使用;（2）组织学;（3）疾病表现;（4）体力状态;（5）既往含铂药物化疗;（6）盆腔疾病;（7）既往盆腔放疗;（8）靶病变位置。生存分析采用Kaplan-Meier曲线，对数秩检验，Wilcoxon检验，和考克斯比例风险模型结合倾向评分matching.ResultsAdding贝伐单抗紫杉醇加卡铂显示出显着增加的完全反应，与非用户。在考克斯回归风险模型中，贝伐珠单抗的使用倾向于显示更好的OS，但无统计学显著性。倾向评分匹配后，加入贝伐单抗紫杉醇加卡铂显示了一个显着更好的OS单变量分析使用Wilcoxon检验，而不是通过log-rank test. ConclusionAdditing贝伐单抗紫杉醇加卡铂复发，持续或晚期宫颈癌患者在真实的世界的预后影响有限。需要进一步有效的二线治疗来延长复发性、持续性或晚期宫颈癌患者的OS。
ObjectiveRecent randomized phase III trial has shown significant benefit in overall survival (OS) for patients with advanced cervical cancer by adding bevacizumab to conventional chemotherapy. The aim of this study was to evaluate the prognostic impact for Japanese recurrent, persistent, or metastatic cervical cancer patients where bevacizumab was added to paclitaxel plus carboplatin.Materials and methodsA retrospective analysis was performed on 90 patients with recurrent, persistent, or metastatic cervical cancer mainly treated by paclitaxel plus carboplatin between 2005 and 2019 at our hospital. Data for the following clinicopathological variables were analyzed: (1) bevacizumab use; (2) histology; (3) disease presentation; (4) performance status; (5) prior chemotherapy containing platinum agent; (6) pelvic disease; (7) prior pelvic radiotherapy; (8) location of target lesions. Survival analysis was performed using Kaplan–Meier curves, log-rank tests, Wilcoxon tests, and Cox proportional hazards models combined with propensity score matching.ResultsAdding bevacizumab to paclitaxel plus carboplatin showed significantly increased complete response to compared with that of non-users. In a Cox regression hazard model, bevacizumab use tended to show better OS though without statistically significance. After propensity score matching, adding bevacizumab to paclitaxel plus carboplatin showed a significant better OS by univariate analysis using Wilcoxon test, not by log-rank test.ConclusionAdding bevacizumab to paclitaxel plus carboplatin showed a limited prognostic impact for recurrent, persistent or advanced cervical cancer patients in the real world. Further effective second-line treatments are needed to prolong OS of patients with recurrent, persistent or advanced cervical cancer.