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原发性手术至紫杉烷联合铂类化疗开始的时间间隔与晚期上皮性卵巢癌患者临床结局的关系:一项意大利多中心回顾性研究结果

Relationship between time interval from primary surgery to the start of taxane- plus platinum-based chemotherapy and clinical outcome of patients with advanced epithelial ovarian cancer: results of a multicenter retrospective Italian study.

作者信息

Gadducci Angiolo, Sartori Enrico, Landoni Fabio, Zola Paolo, Maggino Tiziano, Maggioni Angelo, Cosio Stefania, Frassi Eleonora, LaPresa Maria Teresa, Fuso Luca, Cristofani Renza

机构信息

Department of Gynecology and Obstetrics, University of Pisa, Pisa, Italy.

出版信息

J Clin Oncol. 2005 Feb 1;23(4):751-8. doi: 10.1200/JCO.2005.03.065. Epub 2004 Dec 21.

Abstract

PURPOSE

To assess whether the interval from primary surgery to the start of taxane- plus platinum-based chemotherapy has any impact on the clinical outcome of advanced ovarian cancer patients.

PATIENTS AND METHODS

The study was conducted on 313 patients who underwent surgery followed by taxane- plus platinum-based chemotherapy. The median follow-up of survivors was 30.7 months (range, 6 to 109 months).

RESULTS

The 25%, 50%, and 75% quantiles of intervals from surgery to the start of chemotherapy were 11, 21, and 31 days, respectively. After the sixth cycle, 102 patients achieved a pathologic complete response at second-look surgery and 98 obtained a clinical complete response but were not submitted to second-look surgery. Taking into consideration the best assessed response, a complete (either clinical or pathologic) response was found in 200 patients. Residual disease (< or = 1 v > 1 cm; P < .0001) and ascites (absent v present; P = .003) were independent predictive factors for achieving a complete response, whereas residual disease (P = .001) and stage (IIc to III v IV; P = .04) were independent prognostic variables for survival. Conversely, statistical analyses failed to detect significant differences in complete response rates and survival among patients with an interval from surgery to chemotherapy shorter than 11 days, 12 to 21 days, 22 to 31 days, and longer than 31 days.

CONCLUSION

The interval from surgery to the start of taxane- plus platinum-based chemotherapy seems to have neither a predictive value for response to treatment nor a prognostic relevance for survival of advanced ovarian cancer patients.

摘要

目的

评估从初次手术至开始紫杉烷加铂类化疗的间隔时间对晚期卵巢癌患者临床结局是否有影响。

患者与方法

对313例行手术并接受紫杉烷加铂类化疗的患者进行研究。存活患者的中位随访时间为30.7个月(范围6至109个月)。

结果

从手术至开始化疗的间隔时间的第25%、50%和75%分位数分别为11天、21天和31天。第六周期后,102例患者在二次探查手术时达到病理完全缓解,98例获得临床完全缓解但未接受二次探查手术。考虑最佳评估反应,200例患者出现完全(临床或病理)缓解。残余病灶(≤1 cm与>1 cm;P<0.0001)和腹水(无与有;P = 0.003)是实现完全缓解的独立预测因素,而残余病灶(P = 0.001)和分期(IIc至III期与IV期;P = 0.04)是生存的独立预后变量。相反,统计分析未发现手术至化疗间隔时间短于11天、12至21天、22至31天以及长于31天的患者在完全缓解率和生存率方面存在显著差异。

结论

从手术至开始紫杉烷加铂类化疗的间隔时间似乎对晚期卵巢癌患者的治疗反应既无预测价值,对生存也无预后意义。

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