Pautier P, Ribrag V, Duvillard P, Rey A, Elghissassi I, Sillet-Bach I, Kerbrat P, Mayer F, Lesoin A, Brun B, Crouet H, Barats J C, Morice P, Lhommé C
Department of Medical Oncology, Institut Gustave-Roussy, Villejuif, France.
Ann Oncol. 2007 Dec;18(12):1985-9. doi: 10.1093/annonc/mdm376. Epub 2007 Aug 30.
The evaluation of first-line intensive combination therapy in small cell carcinoma of the ovary (SCCO).
Debulking surgery; four to six cycles of chemotherapy with cisplatin (P) 80 mg/m(2) day 1, adriamycin (A) 40 mg/m(2) day 1, vepeside (V) 75 mg/m(2)/day days 1-3, cyclophosphamide (EP) 300 mg/m(2)/day days 1-3, every 3 weeks and granulocyte colony-stimulating factor with, in case of a complete remission, high-dose chemotherapy with carboplatin, vepeside, cyclophosphamide and stem-cell support.
Twenty-seven patients (median age 25 years); International Federation of Gynecology and Obstetrics stage: five I, four IIC, 17 IIIC-IV and one unknown. Twenty patients underwent complete surgery. Eight patients progressed under chemotherapy. Among 18 patients in complete response (CR), 10 received high-dose chemotherapy (CT) (three stem-cell collection failures, two protocol violations, two disease progression and one refusal). The main grade 3-4 toxic effects were hematologic. There were eight relapses among the 18 CR, four of which were pelvic alone. Among the 27 patients, 13 died and 10 patients are in CR1, three in CR2. The median follow-up is 37 months (8-166) and the median duration of the 18 CR is 30 months (5-111). Overall survival at 1 and 3 years is 58% [confidence interval (CI) 40% to 75%] and 49% (CI 30% to 67%).
Initial dose-intensive therapy achieves interesting overall survival in SCCO.
卵巢小细胞癌（SCCO）一线强化联合治疗的评估。
肿瘤细胞减灭术；采用顺铂（P）80mg/m²第1天、阿霉素（A）40mg/m²第1天、依托泊苷（V）75mg/m²/天第1 - 3天、环磷酰胺（EP）300mg/m²/天第1 - 3天进行4至6个周期化疗，每3周一次，若完全缓解则使用粒细胞集落刺激因子，并行卡铂、依托泊苷、环磷酰胺大剂量化疗及干细胞支持治疗。
27例患者（中位年龄25岁）；国际妇产科联盟分期：5例Ⅰ期，4例ⅡC期，17例ⅢC - Ⅳ期，1例分期不明。20例患者接受了完整手术。8例患者在化疗期间病情进展。18例完全缓解（CR）的患者中，10例接受了大剂量化疗（CT）（3例干细胞采集失败，2例违反方案，2例疾病进展，1例拒绝）。主要的3 - 4级毒性反应为血液学毒性。18例CR患者中有8例复发，其中4例仅为盆腔复发。27例患者中，13例死亡，10例处于CR1期，3例处于CR2期。中位随访时间为37个月（8 - 166个月），18例CR患者的中位缓解持续时间为30个月（5 - 111个月）。1年和3年总生存率分别为58%[置信区间（CI）40%至75%]和49%（CI 30%至67%）。
初始剂量强化治疗在卵巢小细胞癌中取得了令人满意的总生存率。
