Takano Masashi, Sugiyama Toru, Yaegashi Nobuo, Suzuki Mitsuaki, Tsuda Hiroshi, Sagae Satoru, Udagawa Yasuhiro, Kuzuya Kazuo, Kigawa Junzo, Takeuchi Satoshi, Tsuda Hitoshi, Moriya Takuya, Kikuchi Yoshihiro
Department of Obstetrics and Gynecology, National Defense Medical College, Namiki 3-2, Tokorozawa, Saitama, 359-8513, Japan.
Int J Clin Oncol. 2007 Aug;12(4):256-60. doi: 10.1007/s10147-007-0670-1. Epub 2007 Aug 20.
Irinotecan hydrochloride, a topoisomerase I inhibitor, has been preliminarily recognized as an effective agent against clear cell carcinoma of the ovary (CCC), but there are few clinical data. Our aim was to compare progression-free survival (PFS) between patients treated with irinotecan hydrochloride and cisplatin (CPT-P) and those with treated with paclitaxel and carboplatin (TC).
One hundred and seventeen patients at International Federation of Gynecology and Obstetrics (FIGO) stages Ic (ascites/malignant washing) - IV were identified by scanning the medical records of ten Japanese hospitals. After complete surgical staging procedures including lymphadenectomy, 35 patients received CPT-P and 82 patients received TC. The PFS and overall survival of the two groups were compared using the Kaplan-Meier method.
There was no significant difference in median age, performance status, FIGO stage, rate of optimal cytoreduction, or follow-up period between the CPT-P and TC groups. Two-year and 5-year PFS was 48% and 40%, respectively, in the TC group and 55% and 55%, respectively, in the CPT-P group (P = 0.31). Multiple regression analysis revealed that only residual tumor was an independent prognostic factor for PFS (P < 0.01).
CPT-P showed a potential therapeutic effect, at least no less than that of TC therapy. Although there was no significant survival benefit in the present retrospective analysis, we recommend that the CPT-P regimen be evaluated in a larger, prospective, clinical trial.
盐酸伊立替康是一种拓扑异构酶I抑制剂，已被初步认定为治疗卵巢透明细胞癌（CCC）的有效药物，但临床数据较少。我们的目的是比较接受盐酸伊立替康和顺铂（CPT-P）治疗的患者与接受紫杉醇和卡铂（TC）治疗的患者的无进展生存期（PFS）。
通过查阅十家日本医院的病历，确定了117例国际妇产科联盟（FIGO）分期为Ic期（腹水/恶性腹水）至IV期的患者。在完成包括淋巴结清扫在内的完整手术分期程序后，35例患者接受CPT-P治疗，82例患者接受TC治疗。使用Kaplan-Meier方法比较两组的PFS和总生存期。
CPT-P组和TC组在中位年龄、体能状态、FIGO分期、最佳细胞减灭率或随访期方面无显著差异。TC组的两年和五年PFS分别为48%和40%，CPT-P组分别为55%和55%（P = 0.31）。多元回归分析显示，仅残留肿瘤是PFS的独立预后因素（P < 0.01）。
CPT-P显示出潜在的治疗效果，至少不低于TC治疗。尽管在目前的回顾性分析中没有显著的生存获益，但我们建议在更大规模的前瞻性临床试验中评估CPT-P方案。
