Department of Medical Oncology, Christie Hospital, Manchester, UK.
Department of Medical Oncology, Instituto Catalan de Oncologia, Barcelona, Spain.
Ann Oncol. 2012 Oct;23(10):2763-2770. doi: 10.1093/annonc/mds070. Epub 2012 Apr 6.
To describe chemotherapy treatment patterns and clinical outcomes in metastatic soft tissue sarcoma (mSTS) patients with favorable response to chemotherapy.
Multicenter (25) multi-country (9) retrospective chart review of mSTS patients with favorable response to chemotherapy, defined as stable disease or better following four cycles.
Two hundred and thirteen patients (58% female; mean age 54.7 years) received a mean of 2.7 lines of chemotherapy and 5.2 cycles per line. The most common first-line regimens were doxorubicin (34%) and anthracycline plus ifosfamide (30%). Favorable response was achieved by 83% to first-line and 42% and 38% in second- and third-line chemotherapy. The most common reason for chemotherapy discontinuation in lines with a favorable response was reaching a predefined number of cycles in first line (64% of 213) and disease progression in second or later lines (41% of 138). The mean time off chemotherapy was 38.0 weeks after first line, falling to 2.7-6.4 weeks in second or later lines. Median overall and progression-free survival were 23.5 (95% confidence interval 20.5-28.1) and 8.3 (7.4-9.9) months from first favorable response to chemotherapy.
mSTS patients achieving favorable response to chemotherapy have poor outcomes. Additional treatment options are needed.
描述化疗治疗模式和临床结局转移性软组织肉瘤(mSTS)患者对化疗有良好反应。
对化疗有良好反应的 mSTS 患者(定义为稳定疾病或更好,以下简称有利反应)进行多中心(25)多国(9)回顾性图表审查。
213 名患者(58%为女性;平均年龄 54.7 岁)接受了平均 2.7 线化疗,每线接受 5.2 个周期。最常见的一线方案是多柔比星(34%)和蒽环类药物加异环磷酰胺(30%)。一线治疗的有利反应率为 83%,二线和三线治疗的有利反应率分别为 42%和 38%。在有良好反应的线中,停止化疗的最常见原因是达到一线预设周期数(213 例中的 64%)和二线或以后线疾病进展(138 例中的 41%)。一线治疗后平均化疗中断时间为 38.0 周,二线或以后线下降至 2.7-6.4 周。从第一次化疗有利反应开始,中位总生存期和无进展生存期分别为 23.5(95%置信区间 20.5-28.1)和 8.3(7.4-9.9)个月。
对化疗有良好反应的 mSTS 患者预后不良。需要额外的治疗选择。