Inoue M, Nakanishi K, Ueda G, Tanizawa O
Department of Obstetrics and Gynecology, Osaka University Medical School, Japan.
Am J Clin Oncol. 1992 Feb;15(1):1-6. doi: 10.1097/00000421-199202000-00001.
Despite high primary response rates with cisplatin-based combination chemotherapy, the overall survival rate for advanced ovarian cancer remains unsatisfactory. This prompted us to design a new systematic approach using a combination chemotherapy consisting of cisplatin, doxorubicin, and cyclophosphamide (PAC), namely, cyclic PAC chemotherapy. This is a 3-step chemotherapy with 3 courses of the PAC regimen in each step. It was administered for 18 months to patients with clinical Stage Ic-IV ovarian cancer, after cytoreductive surgery. In the present study, the cyclic PAC, brief PAC, and FAM (5-Fu, an alkylating agent, and mitomycin C) groups included 27 cases, 34 cases, and 38 cases, respectively. Treatment of Stage Ic-IV disease by cyclic PAC improved the outcome (57% estimated 5-year survival rate) compared to brief-PAC and FAM (20% and 32%, respectively). The outcome for patients with Stage III or IV ovarian cancer was also superior for the cyclic-PAC group compared to the brief-PAC and FAM groups (cyclic-PAC 44%, brief-PAC 9%, and FAM 0% estimated 5-year survival rates). Cyclic PAC chemotherapy was thus found to be capable of dramatically improving the long-term survival rate of ovarian cancer patients.
尽管基于顺铂的联合化疗有较高的初始缓解率，但晚期卵巢癌的总体生存率仍不尽人意。这促使我们设计一种新的系统方法，即使用由顺铂、阿霉素和环磷酰胺组成的联合化疗方案（PAC），也就是循环PAC化疗。这是一种分三步的化疗方法，每一步包含3个疗程的PAC方案。在进行肿瘤细胞减灭术后，对临床分期为Ic-IV期的卵巢癌患者实施该化疗方案18个月。在本研究中，循环PAC组、简化PAC组和FAM组（5-氟尿嘧啶、一种烷化剂和丝裂霉素C）分别包含27例、34例和38例患者。与简化PAC组和FAM组相比，采用循环PAC方案治疗Ic-IV期疾病可改善预后（估计5年生存率为57%）（简化PAC组和FAM组分别为20%和32%）。与简化PAC组和FAM组相比，循环PAC组中III期或IV期卵巢癌患者的预后也更优（循环PAC组估计5年生存率为44%，简化PAC组为9%，FAM组为0%）。因此，发现循环PAC化疗能够显著提高卵巢癌患者的长期生存率。
