Bloss Jeffrey D, Brady Mark F, Liao Shu Yuan, Rocereto Thomas, Partridge Edward E, Clarke-Pearson Daniel L
Department of Obstetrics and Gynecology, Ellis Fischel Cancer Center, University of Missouri Health Sciences Center, Columbia, MO 65203, USA.
Gynecol Oncol. 2003 Apr;89(1):148-54. doi: 10.1016/s0090-8258(03)00068-4.
The goals of this study were first, to assess the clinical effectiveness of cisplatin and cyclophosphamide in a phase II study involving a well-defined group of women with extraovarian peritoneal serous papillary carcinoma (EPSPC); and second, to compare these results with those of a group of patients with papillary serous ovarian carcinoma (PSOC) who received identical therapy.
After primary surgery, patients were treated with cisplatin 75 mg/m(2) and cyclophosphamide 750 mg/m(2) every 21 days for six cycles. Patient demographics, tumor characteristics, clinical and surgical response to treatment, progression-free survival, and overall survival were evaluated. These patients were then compared with patients with PSOC who received identical treatment on a separate protocol.
Women with a diagnosis of tended to be older that those with EPSPC PSOC (median age: 65.8 years vs 60.3 years, P = 0.04). The estimated probability of clinical response (complete and partial) to the treatment regimen for EPSPC was 65% (95% confidence interval [CI]: 41-85%) compared with 59% (95% CI: 47-71%) for women with PSOC. Surgical complete responses were similar (20% vs 19%) in the two patient groups. Additionally, the death rates did not significantly differ between the two groups (hazard ratio: 1.25, 95% CI: 0.834-1.88).
Women with EPSPC and PSOC exhibit a similar probability of response to cisplatin and cyclophosphamide and a similar overall survival. Based on these findings and the fact that results of ovarian cancer trials are frequently extrapolated to patients with EPSPC, it is reasonable to include EPSPC patients in future large-scale treatment trials involving patients with advanced ovarian cancer.
本研究的目标首先是在一项II期研究中评估顺铂和环磷酰胺对一组明确的卵巢外腹膜浆液性乳头状癌(EPSPC)女性患者的临床疗效;其次是将这些结果与接受相同治疗的一组浆液性乳头状卵巢癌(PSOC)患者的结果进行比较。
初次手术后,患者每21天接受一次顺铂75mg/m²和环磷酰胺750mg/m²治疗,共六个周期。评估患者的人口统计学特征、肿瘤特征、对治疗的临床和手术反应、无进展生存期和总生存期。然后将这些患者与在另一个方案中接受相同治疗的PSOC患者进行比较。
诊断为PSOC的女性往往比EPSPC患者年龄更大(中位年龄:65.8岁对60.3岁,P = 0.04)。EPSPC患者对治疗方案的临床反应(完全缓解和部分缓解)估计概率为65%(95%置信区间[CI]:41 - 85%),而PSOC女性患者为59%(95%CI:47 - 71%)。两个患者组的手术完全缓解率相似(20%对19%)。此外,两组的死亡率没有显著差异(风险比:1.25,95%CI:0.834 - 1.88)。
EPSPC和PSOC女性对顺铂和环磷酰胺的反应概率相似,总生存期也相似。基于这些发现以及卵巢癌试验结果经常外推至EPSPC患者这一事实,将EPSPC患者纳入未来涉及晚期卵巢癌患者的大规模治疗试验是合理的。