Farley John H, Tian Chunqiao, Rose G Scott, Brown Carol L, Birrer Michael, Maxwell G Larry
Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20832, USA.
Cancer. 2009 Sep 15;115(18):4210-7. doi: 10.1002/cncr.24482.
The objectives of this study were to confirm whether racial disparity exists with regard to outcome between black women and white women with ovarian cancer and to identify factors associated with the administration of adjuvant treatment that had an impact on survival.
A retrospective review of 97 black women and 1392 white women with International Federation of Gynecology and Obstetrics stage III/IV ovarian carcinoma was performed. All patients received paclitaxel combined with cisplatin while participating in 1 of 7 Gynecologic Oncology Group clinical trials. The treatment parameters that were reviewed included relative dose, relative time, and relative dose intensity. The treatment parameters and outcomes were compared between black patients and white patients.
There were no differences in relative dose (0.90 vs 0.89), relative time (1.02 vs 0.99), or relative dose intensity (0.90 vs 0.91) received between black patients and white patients. Black women had less grade 3 and 4 leukopenia (53% vs 63%; P<.05) and gastrointestinal toxicity (10% vs 19%; P<.05) than white women. Performance status>0, age>or=70 years, and mucinous histology were associated with not completing treatment (P<.001). The median progression-free survival was 16.2 months for black patients and 16.1 months for white patients, and the median overall survival was 37.9 months and 39.7 months, respectively (P>.05 for all).
When they received similar treatment, there was no difference in clinical outcome between black women and white women with advanced stage epithelial ovarian cancer when they received similar treatment as participants in Gynecologic Oncology Group clinical trials. Black patients may experience less severe gastrointestinal toxicity or leukopenia compared with whites when treated with platinum-based chemotherapy.
本研究的目的是确认患有卵巢癌的黑人女性和白人女性在预后方面是否存在种族差异，并确定与辅助治疗的实施相关且对生存有影响的因素。
对97名患有国际妇产科联盟III/IV期卵巢癌的黑人女性和1392名白人女性进行了回顾性研究。所有患者在参与7项妇科肿瘤学组临床试验中的1项时均接受了紫杉醇联合顺铂治疗。所审查的治疗参数包括相对剂量、相对时间和相对剂量强度。比较了黑人患者和白人患者的治疗参数及预后。
黑人患者和白人患者在接受的相对剂量（0.90对0.89）、相对时间（1.02对0.99）或相对剂量强度（0.90对0.91）方面没有差异。黑人女性3级和4级白细胞减少症（53%对63%；P<0.05）和胃肠道毒性（10%对19%；P<0.05）比白人女性少。体能状态>0、年龄≥70岁和黏液性组织学与未完成治疗相关（P<0.001）。黑人患者的无进展生存期中位数为16.2个月，白人患者为16.1个月，总生存期中位数分别为37.9个月和39.7个月（所有P>0.05）。
当患有晚期上皮性卵巢癌的黑人女性和白人女性作为妇科肿瘤学组临床试验的参与者接受相似治疗时，她们的临床预后没有差异。与白人相比，黑人患者在接受铂类化疗时可能经历较轻的胃肠道毒性或白细胞减少症。
