Department of Medical Oncology, Nippon Medical School, Musashikosugi Hospital, 1-396 Kosugi-machi, Nakahara-ku, Kawasaki-City, Kanagawa Prefecture, Japan.
Ann Oncol. 2011 Dec;22 Suppl 8:viii29-viii32. doi: 10.1093/annonc/mdr468.
Paclitaxel and carboplatin given every 3 weeks is the current standard treatment in first-line chemotherapy regimens for ovarian cancer. The concept of 'dose-dense therapy' is based on the hypothesis that a shortening interval of the doses of cytotoxic agents will be more effective for tumor-cell kill. Recently published phase III trials in breast cancer have shown that dose-dense weekly paclitaxel improves response and survival. The Japanese Gynecologic Oncology Group reported a phase III study comparing the conventional 3-weekly paclitaxel and carboplatin schedule versus dose-dense weekly paclitaxel and 3-weekly carboplatin for advanced epithelial ovarian cancer, fallopian tube cancer or primary peritoneal cancer. The progression-free survival, as the primary endpoint of this study, was significantly prolonged with the dose-dense treatment [28 versus 17.2 months; hazard ratio (HR): 0.71; 95% confidence interval (CI): 0.58-0.88; P=0.0015], as was the overall survival at 3 years (72.1% versus 65.1%; HR 0.75; 95% CI: 0.57-0.98; P=0.03). Dose-dense weekly paclitaxel plus carboplatin represents a new treatment option in women with advanced epithelial ovarian cancer.
紫杉醇和卡铂每 3 周给药是卵巢癌一线化疗方案中的当前标准治疗。“剂量密集型治疗”的概念基于这样一种假设，即细胞毒药物剂量的间隔缩短将对肿瘤细胞杀伤更有效。最近发表的乳腺癌 III 期试验表明，剂量密集型每周紫杉醇可提高反应率和生存率。日本妇科肿瘤学组报告了一项 III 期研究，比较了常规的每 3 周紫杉醇和卡铂方案与剂量密集型每周紫杉醇和每 3 周卡铂治疗晚期上皮性卵巢癌、输卵管癌或原发性腹膜癌。作为这项研究的主要终点，无进展生存期显著延长，密集治疗组为 28 个月，而常规治疗组为 17.2 个月[风险比（HR）：0.71；95%置信区间（CI）：0.58-0.88；P=0.0015]，3 年总生存率也有显著提高（72.1%对 65.1%；HR 0.75；95% CI：0.57-0.98；P=0.03）。剂量密集型每周紫杉醇加卡铂代表了晚期上皮性卵巢癌妇女的一种新的治疗选择。
