Möbus Volker, Kieback Dirk G, Kaubitzsch Sabine K
Department of Obstetrics and Gynecology, Städtische Kliniken Frankfurt-Hoechst, Frankfurt, Germany.
Anticancer Res. 2007 May-Jun;27(3B):1581-7.
This meta-analysis compares the feasibility, safety and clinical outcome of long-term therapy with topotecan vs. standard treatment duration in patients with recurrent ovarian cancer.
Data of 523 patients from five clinical trials were reviewed and retrospectively allocated into two groups. Those patients who received 6 or fewer courses were compared to those with 7 or more courses of intravenous topotecan. Response rates, overall survival and toxicity profiles were compared between these groups.
One hundred and fifty-two (29%) patients received 7 or more courses and 371 patients (71%) received up to 6 courses of topotecan. Hematological toxicity was significant but similar in both treatment groups and was not cumulative. Non-hematological toxicity was generally mild. Eighty-seven (17%) patients responded to topotecan treatment, 66 of these patients received 7 or more courses of therapy. In total, 14 patients experienced their initial response at or after course 6 of therapy. Within the subset of patients with response or disease stabilization at course 6, those who stopped treatment at course 6 for reasons other than progressive disease or adverse events had a median survival of 83.6 weeks and those who continued treatment for longer than 6 courses had a significantly longer median survival of 107.0 weeks.
Chemotherapy with 7 or more courses of topotecan in recurrent ovarian cancer is feasible with no evidence of cumulative toxicity. The results of this retrospective analysis suggest a potential for late response and a survival benefit for those patients without disease progression who continue topotecan therapy beyond 6 cycles of treatment.
本荟萃分析比较了拓扑替康长期治疗与标准治疗疗程在复发性卵巢癌患者中的可行性、安全性和临床结局。
回顾了来自五项临床试验的523例患者的数据，并将其回顾性地分为两组。将接受6个或更少疗程的患者与接受7个或更多疗程静脉注射拓扑替康的患者进行比较。比较两组之间的缓解率、总生存期和毒性特征。
152例（29%）患者接受了7个或更多疗程的治疗，371例（71%）患者接受了最多6个疗程的拓扑替康治疗。血液学毒性显著，但在两个治疗组中相似，且无累积性。非血液学毒性一般较轻。87例（17%）患者对拓扑替康治疗有反应，其中66例患者接受了7个或更多疗程的治疗。总共有14例患者在治疗第6个疗程或之后出现初始反应。在第6个疗程时出现反应或疾病稳定的患者亚组中，因疾病进展或不良事件以外的原因在第6个疗程停止治疗的患者中位生存期为83.6周，而继续治疗超过6个疗程的患者中位生存期显著更长，为107.0周。
复发性卵巢癌患者接受7个或更多疗程的拓扑替康化疗是可行的，且无累积毒性的证据。这项回顾性分析的结果表明，对于那些在6个周期治疗后疾病未进展且继续接受拓扑替康治疗的患者，可能存在延迟反应和生存获益。
