Results of a prospective dose-intensive regimen in 27 patients with small cell carcinoma of the ovary of the hypercalcemic type
Results of a prospective dose-intensive regimen in 27 patients with small cell carcinoma of the ovary of the hypercalcemic type
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DOI：
10.1093/annonc/mdm376
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发表时间：
2007-12-01
影响因子：
50.5
通讯作者：
Lhomme, C.
中科院分区：
文献类型：
--
作者：
Pautier, P.;Ribrag, V.;Lhomme, C.
背景资料：卵巢小细胞癌（SCCO）一线强化联合治疗的评价。患者和方法：肿瘤减瘤手术;化疗4 - 6个周期，顺铂（P）80 mg/m2/天，阿霉素（A）40 mg/m2/天，vepeside（V）75 mg/m2/天，环磷酰胺（EP）300 mg/m2/天，每3周和粒细胞集落刺激因子，在完全缓解的情况下，高剂量化疗与卡铂，vepeside，环磷酰胺和干细胞support.Results：27例患者（中位年龄25岁）;国际妇产科联合会阶段：五个I，四个IIC，17 IIIC-IV和一个未知。20例患者接受了完整手术。8例患者在化疗期间进展。在18例完全缓解（CR）患者中，10例接受了大剂量化疗（CT）（3例干细胞采集失败，2例违反方案，2例疾病进展和1例拒绝）。主要的3-4级毒性反应是血液学。在18例CR中有8例复发，其中4例仅为盆腔复发。27例患者中，死亡13例，CR 1 10例，CR2 3例。中位随访时间为37个月（8-166），18例CR的中位持续时间为30个月（5-111）。1年和3年的总生存率分别为58% [置信区间（CI）40%~ 75%]和49%（CI 30%~ 67%）。结论：初始剂量强化治疗可使SCCO患者的总生存率提高。
Background: The evaluation of first-line intensive combination therapy in small cell carcinoma of the ovary (SCCO).Patients and methods: Debulking surgery; four to six cycles of chemotherapy with cisplatin (P) 80 mg/m(2) day 1, adriamycin (A) 40 mg/m(2) day 1, vepeside (V) 75 mg/m(2)/day days 1-3, cyclophosphamide (EP) 300 mg/m(2)/day days 1-3, every 3 weeks and granulocyte colony-stimulating factor with, in case of a complete remission, high-dose chemotherapy with carboplatin, vepeside, cyclophosphamide and stem-cell support.Results: Twenty-seven patients (median age 25 years); International Federation of Gynecology and Obstetrics stage: five I, four IIC, 17 IIIC-IV and one unknown. Twenty patients underwent complete surgery. Eight patients progressed under chemotherapy. Among 18 patients in complete response (CR), 10 received high-dose chemotherapy (CT) (three stem-cell collection failures, two protocol violations, two disease progression and one refusal). The main grade 3-4 toxic effects were hematologic. There were eight relapses among the 18 CR, four of which were pelvic alone. Among the 27 patients, 13 died and 10 patients are in CR1, three in CR2. The median follow-up is 37 months (8-166) and the median duration of the 18 CR is 30 months (5-111). Overall survival at 1 and 3 years is 58% [confidence interval (CI) 40% to 75%] and 49% (CI 30% to 67%).Conclusions: Initial dose-intensive therapy achieves interesting overall survival in SCCO.