Barrett S V, Paul J, Hay A, Vasey P A, Kaye S B, Glasspool R M
Department of Medical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK.
Ann Oncol. 2008 May;19(5):898-902. doi: 10.1093/annonc/mdm606. Epub 2008 Feb 13.
Previous studies have indicated an association between obesity and poor survival in several tumour types, including ovarian cancer. We sought to test the hypothesis that obesity reduces survival in a large, well-characterised and relatively homogeneous cohort of ovarian cancer patients.
The relationship between body mass index (BMI) and overall survival (OS) and progression-free survival (PFS) in 1067 patients participating in the Scottish Randomised Trial in Ovarian Cancer I trial was assessed. All patients received first-line carboplatin/taxane chemotherapy. The dose of carboplatin was determined by a measured glomerular filtration rate (GFR), ensuring accurate dosing in all categories of BMI and the dose of taxane was not capped. Patients were assigned to one of four categories: underweight (BMI < 18.5), ideal weight (BMI 18.5-24.9), overweight (BMI 25-29.9) or obese (BMI >or= 30).
There were neither statistically significant differences in PFS or OS between these four groups nor were there any differences in taxane or carboplatin dose intensity. Furthermore, there was no association between BMI and tumour stage or grade at presentation, or completeness of debulking surgery.
Obese patients with epithelial ovarian cancer do not have a poorer prognosis, provided that they receive optimal doses of chemotherapy based on measured GFR and actual body weight.
既往研究表明,肥胖与包括卵巢癌在内的多种肿瘤类型的不良生存结局相关。我们试图验证肥胖会降低一大群特征明确且相对同质的卵巢癌患者生存率这一假说。
评估了参与苏格兰卵巢癌I期随机试验的1067例患者的体重指数(BMI)与总生存期(OS)及无进展生存期(PFS)之间的关系。所有患者均接受一线卡铂/紫杉烷化疗。卡铂剂量根据实测肾小球滤过率(GFR)确定,以确保在所有BMI类别中给药准确,且紫杉烷剂量不设上限。患者被分为四类之一:体重过轻(BMI < 18.5)、理想体重(BMI 18.5 - 24.9)、超重(BMI 25 - 29.9)或肥胖(BMI≥30)。
这四组之间的PFS或OS均无统计学显著差异,紫杉烷或卡铂的剂量强度也无差异。此外,BMI与初诊时的肿瘤分期、分级或减瘤手术的彻底性之间均无关联。
上皮性卵巢癌肥胖患者若根据实测GFR和实际体重接受最佳剂量化疗,则预后并不更差。