Kim Hee Seung, Kim Jae Weon, Wu Hong Gyun, Chung Hyun Hoon, Park Noh Hyun, Song Yong Sang, Kang Soon Beom, Lee Hyo Pyo
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
J Obstet Gynaecol Res. 2010 Jun;36(3):598-604. doi: 10.1111/j.1447-0756.2010.01223.x.
We sought to compare survival and toxicity between paclitaxel/carboplatin (TC) and doxorubicin/cisplatin (AP) for concurrent chemoradiation (CCR) in intermediate- or high-risk endometrioid endometrial cancer.
The clinical data of 40 patients with intermediate- (FIGO stage IC-IIB, n = 12) or high-risk endometrioid endometrial cancer (FIGO stage IIIA-IVA, n = 28) were reviewed retrospectively between March 2000 and December 2007, who were treated with TC (n = 23, group 1) or AP (n = 17, group 2) for CCR after surgery.
Progression-free survival (PFS) and overall survival (OS) were not different between groups 1 and 2 (median PFS and OS; 35 vs 24 and 76 vs 39 months, respectively, P > 0.05). However, >or=6 cycles of chemotherapy improved PFS compared with 3-5 cycles of chemotherapy (51 vs 21 months, P = 0.04), suggesting that >or=6 cycles of chemotherapy was an independent prognostic factor improving PFS (adjusted HR, 0.27; 95% CI, 0.08 to 0.91; P = 0.04). Grade 3 or 4 hematological and non-hematological, especially, gastrointestinal, toxicities related with chemotherapy during CCR were more common in group 2 than in group 1, whereas there was no difference in grade 3 or 4 late complication by CCR between the 2 groups.
These findings suggest that TC may have comparable efficacy to AP for CCR with lesser toxicity, and >or=6 cycles of chemotherapy may be more beneficial than 3-5 cycles of chemotherapy in intermediate- or high-risk endometrioid endometrial cancer. However, large-scale randomized controlled trials are needed to support these results.
我们试图比较紫杉醇/卡铂（TC）和多柔比星/顺铂（AP）用于中高危子宫内膜样子宫内膜癌同步放化疗（CCR）时的生存率和毒性。
回顾性分析2000年3月至2007年12月期间40例中高危子宫内膜样子宫内膜癌患者的临床资料，这些患者术后接受TC（n = 23，第1组）或AP（n = 17，第2组）进行CCR。
第1组和第2组之间的无进展生存期（PFS）和总生存期（OS）无差异（中位PFS和OS分别为35个月对24个月和76个月对39个月，P>0.05）。然而，与3 - 5周期化疗相比，≥6周期化疗可改善PFS（51个月对21个月，P = 0.04），提示≥6周期化疗是改善PFS的独立预后因素（校正风险比，0.27；95%可信区间，0.08至0.91；P = 0.04）。第2组CCR期间与化疗相关的3级或4级血液学和非血液学毒性，尤其是胃肠道毒性，比第1组更常见，而两组之间CCR引起的3级或4级晚期并发症无差异。
这些结果表明，TC用于CCR时可能与AP疗效相当但毒性较小，并且在中高危子宫内膜样子宫内膜癌中，≥6周期化疗可能比3 - 5周期化疗更有益。然而，需要大规模随机对照试验来支持这些结果。
