Lack of effective systemic therapy for recurrent clear cell carcinoma of the ovary
Lack of effective systemic therapy for recurrent clear cell carcinoma of the ovary
复制标题
DOI：
10.1016/j.ygyno.2006.12.024
复制
发表时间：
2007-05-01
影响因子：
4.7
通讯作者：
Gershenson, David M.
中科院分区：
文献类型：
--
作者：
Crotzer, David R.;Sun, Charlotte C.;Gershenson, David M.
目标。卵巢透明细胞癌是一种侵袭性肿瘤，具有相对化疗耐药和预后不良的特点。这项研究的目的是回顾我们复发性卵巢透明细胞癌的经验，以评估其对全身细胞毒性和激素性药物的反应。所有诊断为卵巢透明细胞癌的患者均在1990年至2002年间在我所就诊，并复习了他们的病历。资格标准是：1)卵巢透明细胞癌的初步诊断，2)可测量的复发疾病，3)用1个或多个系统方案治疗复发疾病，4)充分的临床信息。终点为临床反应、无进展生存期和总生存期。确定了51名接受治疗的复发透明细胞癌患者。这些患者总共接受了105个方案(344个疗程)。在铂敏感型疾病患者(n 22个方案)中，2例(9%)患者对卡铂加紫杉醇再次治疗有部分反应，4例(18%)病情稳定。在对铂耐药的疾病患者(n=83个方案)中，只有1名患者(1%)对吉西他滨有部分反应，而我的患者对两种不同的方案-紫杉醇和吉西他滨有稳定的反应。中位无离子进展生存期为8个月，中位总生存期为18个月。我们的研究结果表明，复发性卵巢透明细胞癌对化疗特别耐药。有必要继续寻找更活跃、更有针对性的特工。(C)2007 Elsevier Inc.保留所有权利。
Objective. Clear cell carcinoma of the ovary is an aggressive tumor characterized by relative chemoresistance and a poor prognosis. The purpose of this study was to review our experience with recurrent clear cell carcinoma of the ovary to evaluate its responsiveness to systemic cytotoxic and hormonal agents.Methods. All patients diagnosed with clear cell carcinoma of the ovary seen at our institution between 1990 and 2002 were identified and their medical records reviewed. Eligibility criteria were: 1) primary diagnosis of clear cell carcinoma of the ovary, 2) measurable recurrent disease, 3) treatment of recurrent disease with 1 or more systemic regimens, and 4) adequate clinical information. End points were clinical response, progression-free survival, and overall survival.Results. Fifty-one patients treated for recurrent clear cell carcinoma were identified. The patients received a total of 105 regimens (344 cycles of therapy). Among patients with platinum-sensitive disease (n 22 regimens), 2 patients (9%) had partial responses to retreatment with carboplatin plus paclitaxel, and 4 (18%) had stable disease. Among patients with platinum-resistant disease (n = 83 regimens), only 1 patient (1%) had a partial response - to gemcitabine - and I patient had stable disease in response to 2 different regimens-paclitaxel and gemcitabine. The median progress ion-free survival was 8 months, and the median overall survival was 18 months.Conclusion. Our findings suggest that recurrent clear cell carcinoma of the ovary is particularly chemoresistant. A continued search for more active, targeted agents is warranted. (c) 2007 Elsevier Inc. All rights reserved.