铂敏感复发性卵巢癌老年患者的不良预后：苏格拉底回顾性研究结果

Poor outcome of elderly patients with platinum-sensitive recurrent ovarian cancer: results from the SOCRATES retrospective study.

作者信息

Pignata Sandro, Ferrandina Gabriella, Scarfone Giovanna, Scollo Paolo, Odicino Franco, Cormio Gennaro, Katsaros Dionyssios, Frigerio Luigi, Mereu Liliana, Ghezzi Fabio, Manzione Luigi, Lauria Rossella, Breda Enrico, Alletti Desiderio Gueli, Ballardini Michela, Vernaglia Alessandra, Sorio Roberto, Tumolo Salvatore, Musso Pietro, Magni Giovanna, Pisano Carmela, Morabito Alessandro

机构信息

Istituto Nazionale Tumori, Napoli, Italy.

出版信息

Crit Rev Oncol Hematol. 2009 Sep;71(3):233-41. doi: 10.1016/j.critrevonc.2008.12.010. Epub 2009 Jan 28.

DOI:10.1016/j.critrevonc.2008.12.010

PMID:19179095

Abstract

BACKGROUND

Elderly patients with ovarian carcinoma have a poorer prognosis compared with their younger counterpart, and this depends in most cases on undertreatment. The aim of this study was to evaluate, retrospectively, the pattern of care and the prognosis of elderly patients with platinum-sensitive recurrent ovarian cancer. The SOCRATES study retrospectively assessed the pattern of care of a cohort of patients with recurrent platinum-sensitive ovarian cancer observed in the years 2000-2002 in 37 Italian centres. Data were collected between April and September 2005.

PATIENTS AND METHODS

Patients with recurrent ovarian cancer with >6 months of platinum free interval were considered eligible. Four-hundred-ninety-three patient files were collected and 425 were considered eligible and analyzed. Ninety-four patients with age >or=70 years and 331 patients with age <70 years were analyzed.

RESULTS

Recurrence free interval (RFI), PS, and number of disease sites were similar among the two groups. A lower proportion of elderly patients underwent secondary cytoreduction (8.9% compared to 23.9%; p=0.0018). The mean number of chemotherapy lines received for recurrence was 2.7 and 2.5 in young and aged patients, respectively. Elderly patients received more frequently at second line single agent platinum than platinum-combination therapy or other non-platinum chemotherapy. The response rate to the second line chemotherapy was higher in younger patients than in the elderly population (CR+PR, younger: 67.2%; elderly: 46.5%; p=0.0004). Median overall survival from recurrence was 30.7 months in the younger patients and 23.6 months in the elderly group (p=0.0037). At multivariate analysis, number of disease sites (>1 vs. 1), performance status at recurrence (2-3 vs. 0-1), RFI (6-12 months vs. >12 months), age at recurrence, were independently associated with survival.

CONCLUSION

Elderly patients with platinum-sensitive recurrent ovarian cancer receive less surgery and chemotherapy. Response to chemotherapy is better in younger patients. Age is an unfavourable factor independently associated to a worst prognosis.

摘要

背景

与年轻患者相比，老年卵巢癌患者的预后较差，在大多数情况下这取决于治疗不足。本研究的目的是回顾性评估铂敏感复发性卵巢癌老年患者的治疗模式和预后。SOCRATES研究回顾性评估了2000年至2002年在意大利37个中心观察到的一组铂敏感复发性卵巢癌患者的治疗模式。数据于2005年4月至9月收集。

患者与方法

铂类药物无治疗间隔>6个月的复发性卵巢癌患者被认为符合条件。收集了493份患者档案，其中425份被认为符合条件并进行分析。分析了94例年龄≥70岁的患者和331例年龄<70岁的患者。

结果

两组患者的无复发生存期（RFI）、体能状态（PS）和疾病部位数量相似。接受二次肿瘤细胞减灭术的老年患者比例较低（8.9%，而年轻患者为23.9%；p = 0.0018）。复发后接受化疗的平均疗程数在年轻患者和老年患者中分别为2.7和2.5。老年患者在二线治疗时更频繁地接受单药铂类治疗，而非铂类联合治疗或其他非铂类化疗。年轻患者对二线化疗的缓解率高于老年患者（完全缓解+部分缓解，年轻患者：67.2%；老年患者：46.5%；p = 0.0004）。复发后的中位总生存期在年轻患者中为30.7个月，在老年组中为23.6个月（p = 0.0037）。多因素分析显示，疾病部位数量（>1个与1个）、复发时的体能状态（2 - 3与0 - 1）、RFI（6 - 12个月与>12个月）、复发时的年龄与生存独立相关。