Bae Jeong Hoon, Lee Joon Mo, Ryu Ki Sung, Lee Yong Seok, Park Yong Gyu, Hur Soo Young, Ahn Woong Shik, Namkoong Seong Eun
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Kangnam St. Mary's Hospital, Catholic University of Korea, Seocho-gu, Seoul, South Korea.
Gynecol Oncol. 2007 Jul;106(1):193-200. doi: 10.1016/j.ygyno.2007.03.019. Epub 2007 Apr 26.
We aimed to evaluate the efficacy and feasibility of treating advanced ovarian cancer with paclitaxel or carboplatin in intraperitoneal hyperthermic chemotherapy (IPHC) during secondary surgery.
We reviewed clinical data of 96 eligible patients with stage Ic-IIIc epithelial ovarian cancer. After primary staging operation and 6-12 cycles of adjuvant chemotherapy, 22 patients were treated with IPHC-paclitaxel (175 mg/m(2)) and 45 patients were treated with IPHC-carboplatin (350 mg/m(2)) during secondary surgery. Survival rates were compared with those of 29 patients treated with only conventional therapy (control group).
In stage III diseases, 5-year survival rates were 84.6% in IPHC-paclitaxel, 63.0% in IPHC-carboplatin (P=0.4098) and 32.8% in control group (vs. IPHC, P=0.0003). Three-year progression-free survival rates in stage III diseases were both 56.3% in IPHC-paclitaxel and IPHC-carboplatin (P=0.8911) and 16.7% in control group (vs. IPHC, P=0.0028). For the relative risk of disease progression yielded from multivariate analyses, hazard ratio of IPHC-paclitaxel was 0.281 (P=0.0039) and that of IPHC-carboplatin was 0.443 (P=0.0083). Like carboplatin (hazard ratio: 0.396, P=0.0004), IPHC-paclitaxel considerably decreased the risk of death (hazard ratio: 0.197, P=0.0253).
In advanced ovarian cancer, IPHC using paclitaxel or carboplatin during secondary surgery could be a candidate for regional consolidation therapy to prolong survival and hinder disease progression.
我们旨在评估在二次手术期间进行腹腔热灌注化疗（IPHC）时，使用紫杉醇或卡铂治疗晚期卵巢癌的疗效和可行性。
我们回顾了96例符合条件的Ⅰc-Ⅲc期上皮性卵巢癌患者的临床资料。在初次分期手术和6-12个周期的辅助化疗后，22例患者在二次手术期间接受了IPHC-紫杉醇（175mg/m²）治疗，45例患者接受了IPHC-卡铂（350mg/m²）治疗。将生存率与29例仅接受传统治疗的患者（对照组）进行比较。
在Ⅲ期疾病中，IPHC-紫杉醇组的5年生存率为84.6%，IPHC-卡铂组为63.0%（P=0.4098），对照组为32.8%（与IPHC组相比，P=0.0003）。Ⅲ期疾病的3年无进展生存率在IPHC-紫杉醇组和IPHC-卡铂组均为56.3%（P=0.8911），对照组为16.7%（与IPHC组相比，P=0.0028）。对于多因素分析得出的疾病进展相对风险，IPHC-紫杉醇的风险比为0.281（P=0.0039），IPHC-卡铂的风险比为0.443（P=0.0083）。与卡铂一样（风险比：0.396，P=0.0004），IPHC-紫杉醇显著降低了死亡风险（风险比：0.197，P=0.0253）。
在晚期卵巢癌中，二次手术期间使用紫杉醇或卡铂进行IPHC可能是一种区域巩固治疗的选择，可延长生存期并阻碍疾病进展。
