Pan Ling-Ya, Jin Ying, Huang Hui-Fang, Shen Keng, Wu Ming, Lang Jing-He
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, PR China.
Ai Zheng. 2003 Nov;22(11):1188-92.
BACKGROUND & OBJECTIVE: Recurrent ovarian cancer is associated with a poor prognosis, and optimal management for this problem is not well defined. The purpose of the study was to evaluate treatment opportunity for patients with recurrent ovarian cancer.
Fifty-four cases of recurrent ovarian cancer during 1990 to 2000 were randomly selected to compare the effect of treatment opportunity on the outcome. All the clinical data related to the recurrent ovarian cancer were collected. The difference in survival was calculated by the Cox model.
The multivariate analysis showed that the platinum-free-interval >6 months and the surgery followed salvage chemotherapy were associated with a significant prolongation of survival for the patients with recurrent ovarian cancer(P< 0.05). The odds ratio was 0.389 for the patients whose platinum-free-interval was more than 6 months as compared to that of the platinum-free-interval < 6 months. The OR was 4.194 for the patients who were only with salvage chemotherapy as compared to that with surgery followed salvage chemotherapy. The numbers of chemotherapy cycles may offer some effect on the survival (P=0.07). The odds ratio(OR) was 0.346 for the patients whose chemotherapy cycles were more than 10 as compared to that of chemotherapy cycles < 6. The timing of the beginning of the retreatment and chemotherapy regiments were failed to demonstrate an improvement in survival(P >0.05).
The treatment opportunity for patients with recurrent ovarian cancer is depend on the platinum-free-interval of the patients. A strategy of secondary surgical cytoreduction followed salvage chemotherapy is suggested for the patients whose platinum-free-interval >6 months. The goal of the treatment for platinum-resistant patients is to improve the quality of life.
复发性卵巢癌预后较差，针对这一问题的最佳治疗方案尚未明确界定。本研究旨在评估复发性卵巢癌患者的治疗时机。
随机选取1990年至2000年间的54例复发性卵巢癌病例，比较治疗时机对预后的影响。收集所有与复发性卵巢癌相关的临床资料。采用Cox模型计算生存差异。
多因素分析显示，无铂间期>6个月且手术联合挽救性化疗与复发性卵巢癌患者的生存期显著延长相关（P<0.05）。无铂间期>6个月的患者与无铂间期<6个月的患者相比，比值比为0.389。仅接受挽救性化疗的患者与手术联合挽救性化疗的患者相比，比值比为4.194。化疗周期数可能对生存有一定影响（P=0.07）。化疗周期>10的患者与化疗周期<6的患者相比，比值比（OR）为0.346。再次治疗开始的时间和化疗方案未能显示出生存改善（P>0.05）。
复发性卵巢癌患者的治疗时机取决于患者的无铂间期。对于无铂间期>6个月的患者，建议采用二次手术减瘤联合挽救性化疗的策略。铂耐药患者的治疗目标是提高生活质量。
