Division of Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Gynecol Oncol. 2010 Mar;116(3):345-50. doi: 10.1016/j.ygyno.2009.11.009. Epub 2009 Dec 2.
Combination intravenous/intraperitoneal (IV/IP) chemotherapy has been shown in three randomized trials to be superior to IV therapy alone in the treatment of advanced ovarian cancer with respect to overall survival (OS). We sought to evaluate the effect of dose modification of IP therapy on completion rates.
From November 1999 until August 2008, all optimally debulked, advanced stage ovarian cancer patients who received adjuvant IP chemotherapy at a single institution were reviewed. The primary endpoint was completion of 6 cycles of IP chemotherapy. This rate was compared to published results from GOG 172. A secondary analysis evaluated completion of chemotherapy based on IP catheter type. Statistical analysis was performed with a chi square test with a significance level of p<0.05.
One hundred and three patients received IP chemotherapy during this period. Seventy-five patients received the modified IV/IP chemotherapy regimen. Sixty-two patients (83%) completed all 6 cycles in our cohort compared to 119 patients (42%) reported in GOG 172 (p=0.0001). Fifty-five patients had a fenestrated catheter (F) and 48 had a non-fenestrated (NF) catheter. Eight patients in each cohort discontinued treatment, for a completion rate of 85.5% in NF and 82.3% in F (p=0.79).
The dose modifications utilized in this study allowed for completion of 6 cycles of adjuvant IP chemotherapy in 83% of patients. Choice of catheter type did not affect completion rates. Continued monitoring of outcomes is planned to compare PFS and OS. The high completion rate may increase acceptance of IP chemotherapy in the community setting.
三项随机试验表明，与单独静脉化疗相比，联合静脉/腹腔内（IV/IP）化疗在治疗晚期卵巢癌方面在总生存期（OS）方面具有优势。我们试图评估腹腔内治疗剂量修改对完成率的影响。
从 1999 年 11 月至 2008 年 8 月，对在一家机构接受辅助性腹腔内化疗的所有最佳减瘤的晚期卵巢癌患者进行了回顾性分析。主要终点是完成 6 个周期的腹腔内化疗。该比率与 GOG 172 的发表结果进行了比较。二次分析根据腹腔内导管类型评估了化疗的完成情况。统计分析采用卡方检验，显著性水平为 p<0.05。
在此期间，有 103 名患者接受了腹腔内化疗。75 名患者接受了改良的 IV/IP 化疗方案。在我们的队列中，有 62 名患者（83%）完成了所有 6 个周期，而 GOG 172 报告的患者为 119 名（42%）（p=0.0001）。55 名患者有一个有孔导管（F），48 名患者有一个无孔导管（NF）。每个队列中有 8 名患者停止治疗，NF 组的完成率为 85.5%，F 组为 82.3%（p=0.79）。
本研究中使用的剂量修改方法使 83%的患者完成了 6 个周期的辅助性腹腔内化疗。导管类型的选择并不影响完成率。计划继续监测结果，以比较无进展生存期和总生存期。高完成率可能会增加社区对腹腔内化疗的接受度。
