Bookman Michael A
University of Arizona Cancer Center, Tucson, Arizona, USA.
Clin Obstet Gynecol. 2012 Mar;55(1):96-113. doi: 10.1097/GRF.0b013e31824b45da.
Advanced-stage epithelial ovarian cancer remains a highly lethal malignancy, despite effective cytoreductive surgery and primary chemotherapy. Phase III studies have evaluated multidrug combinations, dose-dense weekly scheduling, intraperitoneal delivery, neoadjuvant chemotherapy, maintenance therapy, and targeting of angiogenesis. Incremental gains in median progression-free or overall survival have been achieved, but without an impact on overall mortality. Data support intraperitoneal cisplatin, dose-dense weekly paclitaxel, or neoadjuvant chemotherapy with interval cytoreduction in appropriate patients. Encouraging data have emerged using antiangiogenic agents, but with questions regarding optimal timing and patient selection. The use of 3-drug combinations or maintenance chemotherapy is not supported.
尽管有有效的细胞减灭术和一线化疗，但晚期上皮性卵巢癌仍然是一种高度致命的恶性肿瘤。III期研究评估了多药联合、剂量密集的每周给药方案、腹腔给药、新辅助化疗、维持治疗以及血管生成靶向治疗。在无进展生存期或总生存期的中位数方面已取得渐进性改善，但对总体死亡率没有影响。数据支持在合适的患者中使用腹腔顺铂、剂量密集的每周紫杉醇或新辅助化疗联合间隔细胞减灭术。使用抗血管生成药物已出现了令人鼓舞的数据，但在最佳时机和患者选择方面存在问题。不支持使用三联药物联合或维持化疗。
