Neoadjuvant chemotherapy for advanced ovarian cancer: Long-term survival
Neoadjuvant chemotherapy for advanced ovarian cancer: Long-term survival
复制标题
DOI：
10.1006/gyno.1998.5236
复制
发表时间：
1999-01-01
影响因子：
4.7
通讯作者：
Thiel, RP
中科院分区：
文献类型：
--
作者：
Schwartz, PE;Rutherford, TJ;Thiel, RP
目的.本研究的目的是比较新辅助化疗后手术治疗的晚期卵巢癌妇女的无进展生存率和总生存率，与那些常规的细胞减灭术后细胞毒化疗的妇女的无进展生存率和总生存率。和（3）细胞学或组织学标本，并用基于铂的联合化疗治疗，即，新辅助化疗，进行回顾性分析。41例随后接受了细胞减灭术。将其总体生存率和无进展生存率与同期206例连续IIIC期和IV期卵巢上皮癌患者进行常规细胞减灭术后联合铂类药物化疗进行比较。总生存期无统计学差异（P = 0.1578）或新辅助化疗组与常规治疗组之间的无进展生存期（P = 0.5327）尽管新辅助化疗患者年龄较大，（常规治疗患者的中位年龄为67岁[范围为44至85岁] vs中位年龄为60岁[范围为19至79岁]; P < 0.001），并且具有统计学上比常规治疗组差的性能状态（P < 0.001）。新辅助化疗后行肿瘤细胞减灭术的患者与未行手术的患者相比，总生存率有统计学意义的提高（P < 0.0001）。新辅助化疗不会影响晚期卵巢癌患者的生存率。前瞻性随机试验比较新辅助化疗与常规治疗，以确定生活质量的经验和成本/效益的结果，现在是适当的妇女提出与晚期卵巢癌，（C）1999年学术出版社。
Purpose. The aim of this study was to compare the progression-free and overall survivals of women with advanced ovarian cancer treated with neoadjuvant chemotherapy followed by surgery with those treated conventionally with cytoreductive surgery followed by cytotoxic chemotherapy.Materials and Methods, Fifty-nine consecutive women with advanced malignancies compatible with ovarian cancer based on (1) physical examinations, (2) computerized tomography scans, and (3) cytologic or histologic specimens and treated with platinum-based combination chemotherapy, i.e., neoadjuvant chemotherapy, were retrospectively reviewed. Forty-one subsequently underwent cytoreductive surgery. Their overall and progression-free survivals were compared to those of 206 consecutive women with Stage IIIC and IV epithelial ovarian cancers treated with conventional cytoreductive surgery followed by platinum-based combination chemotherapy during the same era.Results. No statistical difference was observed in overall survival (P = 0.1578) or in progression-free survival between the group treated with neoadjuvant chemotherapy and the conventionally treated group (P = 0.5327) despite the neoadjuvant chemotherapy patients being statistically older (median age 67 years [range 44 to 85 years] vs a median age of 60 years [range 19 to 79 years] for conventionally treated patients; P < 0.001) and having a statistically poorer performance status (P < 0.001) than the conventionally treated group. Women undergoing cytoreductive surgery following neoadjuvant chemotherapy had a statistically improved overall survival (P < 0.0001) compared to those who did not undergo surgery.Conclusions. Neoadjuvant chemotherapy does not compromise the survival of women treated for advanced ovarian cancer. Prospective randomized trials comparing neoadjuvant chemotherapy to conventional therapy to determine quality of life experiences and cost/benefit outcomes are now appropriate for women presenting with advanced ovarian cancer, (C) 1999 Academic Press.