Yuan Guang-wen, Wu Ling-ying, Yao Hong-wen, Hou Jin-lin, Li Xiao-guang, Liu Li-ying
Department of Gynecologic Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Zhonghua Zhong Liu Za Zhi. 2009 Sep;31(9):710-3.
To discuss the prognostic factors of recurrent ovarian epithelial carcinoma and to analyze the curative effect of post-relapse treatment.
The clinical records of 293 patients with ovarian epithelial carcinoma were reviewed retrospectively. There were 199 recurrent cases during the following up.
All the 199 patients received chemotherapy. And 173 patients only received chemotherapy. 16 patients received surgery and chemotherapy and the other 10 patients received radiotherapy and chemotherapy. 158 patients received platinum-based chemotherapy again and 41 patients received chemotherapy without platinum. The response rate of all the patients was 43.7% (87/199), the response rate of only chemotherapy was 39.9% (69/173), the response rate of surgery and chemotherapy was 75.0% (12/16), and the response rate of radiotherapy and chemotherapy was 60.0% (6/10). The patients were divided into four groups according to the progression free interval (PFI). The response rates in groups that PFI < or = 6 months, 7 - 12 months, 13 - 24 months and > 24 months were 5.1%, 47.2%, 82.1% and 96.0%, respectively. The median survival time in the 16 patients received second cyto-reductive surgery was 41 months. Multivariate analysis revealed that PFI was significantly correlated with prognosis of recurrent ovarian epithelial carcinoma (OR = 0.589, P = 0.021).
PFI is an individual prognostic factor for survival of recurrent ovarian epithelial carcinoma. PFI is significantly associated with the response rate of chemotherapy. Optimal secondary cytoreductive surgery may improve the overall survival of recurrent patients. The response rate of paclitaxel plus platinum chemotherapy in platinum-sensitive patients is higher than that of other platinum-based chemotherapy.
探讨复发性卵巢上皮癌的预后因素,并分析复发后治疗的疗效。
回顾性分析293例卵巢上皮癌患者的临床资料。随访期间有199例复发。
199例患者均接受了化疗。其中173例仅接受化疗,16例接受了手术及化疗,另10例接受了放疗及化疗。158例再次接受了含铂化疗,41例接受了非铂类化疗。所有患者的缓解率为43.7%(87/199),单纯化疗的缓解率为39.9%(69/173),手术加化疗组的缓解率为75.0%(12/16),放疗加化疗组的缓解率为60.0%(6/10)。根据无进展生存期(PFI)将患者分为四组。PFI≤6个月、7 - 12个月、13 - 24个月和>24个月组的缓解率分别为5.1%、47.2%、82.1%和96.0%。16例行二次肿瘤细胞减灭术患者的中位生存时间为41个月。多因素分析显示PFI与复发性卵巢上皮癌预后显著相关(OR = 0.589;P = 0.021)。
PFI是复发性卵巢上皮癌生存的个体预后因素。PFI与化疗缓解率显著相关。最佳的二次肿瘤细胞减灭术可提高复发患者的总生存期。铂敏感患者中紫杉醇联合铂类化疗的缓解率高于其他含铂化疗。