Markman Maurie, Federico Massimo, Liu P Y, Hannigan Edward, Alberts David
University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
Gynecol Oncol. 2006 Oct;103(1):195-8. doi: 10.1016/j.ygyno.2006.02.024. Epub 2006 Apr 3.
The relationship between survival and early changes in the serum level of the CA-125 antigen in patients with advanced ovarian cancer remains poorly defined.
To explore this issue, the serum CA-125 values from 101 patients with advanced ovarian cancer who participated in a Southwest Oncology Group trial (SWOG 8412), which compared the systemic delivery of cisplatin/cyclophosphamide vs. carboplatin/cyclophosphamide (both delivered every 28 days for 6 cycles) in suboptimal residual stage III and IV ovarian cancer, were evaluated. All patients in this analysis had CA-125 values available for at least 8 weeks following initiation of chemotherapy. Cox proportional hazards regression was used in multivariate analysis to determine the prognostic significance of the CA-125 concentration.
While pretreatment CA-125 values did not correlate with survival, the concentration of this tumor marker 8 weeks after initiation of therapy was a powerful independent prognostic factor. The median survivals for patients (n = 51) with a CA-125 < 35 U/ml, vs. patients (n = 50) with a CA-125 > 35 U/ml, at this time point, were 26 months and 15 months, respectively (P = 0.0001). Further, women with serum CA-125 values <50% of their pretreatment concentration at 8 weeks experienced a median survival of 21 months, compared to only 10 months for individuals with tumor marker levels >50% of their baseline value (P = 0.0003).
Reduction in the serum CA-125 concentration over the initial two cycles of platinum-based chemotherapy is a powerful independent predictor of survival for patients with suboptimal stage III or IV ovarian cancer. Patients without significant declines in CA-125 after two cycles of platinum-based chemotherapy have a particularly poor prognosis.
晚期卵巢癌患者的生存情况与血清CA - 125抗原水平的早期变化之间的关系仍不明确。
为探究此问题，对101例晚期卵巢癌患者的血清CA - 125值进行了评估，这些患者参与了西南肿瘤协作组试验（SWOG 8412），该试验比较了在次优残留的III期和IV期卵巢癌中顺铂/环磷酰胺与卡铂/环磷酰胺的全身给药情况（两者均每28天给药1次，共6个周期）。该分析中的所有患者在化疗开始后至少8周内都有可用的CA - 125值。多因素分析采用Cox比例风险回归来确定CA - 125浓度的预后意义。
虽然治疗前CA - 125值与生存情况无关，但治疗开始8周后该肿瘤标志物的浓度是一个强有力的独立预后因素。在这个时间点，CA - 125 < 35 U/ml的患者（n = 51）与CA - 125 > 35 U/ml的患者（n = 50）的中位生存期分别为26个月和15个月（P = 0.0001）。此外，血清CA - 125值在8周时低于其治疗前浓度50%的女性中位生存期为21个月，而肿瘤标志物水平高于其基线值50%的个体中位生存期仅为10个月（P = 0.0003）。
在基于铂类的化疗最初两个周期中血清CA - 125浓度的降低是次优III期或IV期卵巢癌患者生存的有力独立预测指标。在基于铂类的化疗两个周期后CA - 125没有显著下降的患者预后特别差。
