Zhao Xiao-Dong, Zhang Qiao, Zhang Yi
Department of Obstetrics and Gynecology, Beijing Hospital, Beijing, P. R. China.
Ai Zheng. 2005 Aug;24(8):1002-5.
BACKGROUND & OBJECTIVE: Chemotherapy, which includes selecting appropriate drugs and suitable dose, is necessary to advanced ovarian carcinoma. Whether dose delivery affects prognosis of ovarian cancer is controversial. This study was to investigate the impact of dose delivery of postoperative first-line chemotherapy on prognosis of stage III C epithelial ovarian carcinoma.
Clinical data of 47 stage III C epithelial ovarian carcinoma patients, treated with cisplatin-based adjuvant first-line chemotherapy, were retrospectively analyzed. The relative cumulative dose (CD) and dose intensity (DI) were calculated for each drug and for all drugs combined (namely overall CD and overall DI). The impact of dose delivery on progression-free survival (PFS) and overall survival (OS) was analyzed.
Median overall CD was 0.76, and median overall DI was 0.53; the median CD of cisplatin was 0.78, and the median DI of cisplatin was 0.57; the median CD of paclitaxel was 0.81, and the median DI of paclitaxel was 0.51. Dose delivery had no impact on PFS and OS of the patients. However, in non-paclitaxel chemotherapy subgroup, the higher overall CD, or CD for cisplatin, or DI for cisplatin, the longer PFS (P=0.01, P=0.03, P=0.01) and OS (P=0.01, P=0.04, P=0.01); in paclitaxel chemotherapy subgroup, dose delivery had no impact on PFS and OS. In suboptimal surgery subgroup (residual disease of > 2 cm), the higher DI for cisplatin, the longer PFS; the higher overall CD, or DI for cisplatin, the longer OS. In optimal surgery subgroup (residual disease of < or =2 cm), dose delivery had no impact on PFS and OS. Residual disease was the only independent prognostic factor of epithelial ovarian carcinoma.
The dose delivery below standard level may influence survival of the patients with residual disease of > 2 cm or treated by non-paclitaxel chemotherapy. The diameter of residual disease is the independent prognostic factor of epithelial ovarian carcinoma.
化疗，包括选择合适的药物和剂量，对于晚期卵巢癌是必要的。剂量给予是否影响卵巢癌的预后存在争议。本研究旨在探讨术后一线化疗的剂量给予对ⅢC期上皮性卵巢癌预后的影响。
回顾性分析47例接受以顺铂为基础的辅助一线化疗的ⅢC期上皮性卵巢癌患者的临床资料。计算每种药物以及所有联合药物的相对累积剂量（CD）和剂量强度（DI）（即总CD和总DI）。分析剂量给予对无进展生存期（PFS）和总生存期（OS）的影响。
总CD中位数为0.76，总DI中位数为0.53；顺铂的CD中位数为0.78，顺铂的DI中位数为0.57；紫杉醇的CD中位数为0.81，紫杉醇的DI中位数为0.51。剂量给予对患者的PFS和OS无影响。然而，在非紫杉醇化疗亚组中，总CD、顺铂的CD或顺铂的DI越高，PFS（P = 0.01，P = 0.03，P = 0.01）和OS（P = 0.01，P = 0.04，P = 0.01）越长；在紫杉醇化疗亚组中，剂量给予对PFS和OS无影响。在次优手术亚组（残留病灶＞2 cm）中，顺铂的DI越高，PFS越长；总CD或顺铂的DI越高，OS越长。在最优手术亚组（残留病灶≤2 cm）中，剂量给予对PFS和OS无影响。残留病灶是上皮性卵巢癌唯一的独立预后因素。
低于标准水平的剂量给予可能影响残留病灶＞2 cm或接受非紫杉醇化疗患者的生存。残留病灶直径是上皮性卵巢癌的独立预后因素。
