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“铂类药物敏感性”概念在复发性子宫内膜癌中的适用性:SGSG-012/GOTIC-004/Intergroup 研究。

Applicability of the concept of "platinum sensitivity" to recurrent endometrial cancer: the SGSG-012/GOTIC-004/Intergroup study.

机构信息

Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi 673-8558, Japan.

出版信息

Gynecol Oncol. 2013 Dec;131(3):567-73. doi: 10.1016/j.ygyno.2013.09.021. Epub 2013 Sep 25.

Abstract

OBJECTIVE

The concept of "platinum sensitivity" has been widely applied in the management of recurrent ovarian cancer. This study aimed to evaluate the applicability of this concept to recurrent endometrial cancer.

PATIENTS AND METHODS

In this multicenter retrospective cohort study, the clinical data of patients with recurrent endometrial cancer, who had a history of receiving first-line platinum-based chemotherapy and who received second-line platinum-based chemotherapy at the time of recurrence between January 2005 and December 2009 were reviewed.

RESULTS

A total of 262 patients from 30 centers with initial FIGO stage classifications of I (29), II (23), III (122), and IV (88) were enrolled. In total, 153 endometrioid adenocarcinomas, 34 serous adenocarcinomas, 17 clear cell adenocarcinomas, 36 carcinosarcomas, and 22 "other" tumors were documented. The response rates for patients with platinum-free intervals of <6 months, 6-11 months, 12-23 months, and ≥24 months were 25%, 38%, 61%, and 65%, respectively. The median progression-free survival after second-line platinum-based chemotherapy for patients with platinum-free intervals of <12 months and ≥12 months was 4.4 (95% confidence interval (CI)=3.7-5.8) months and 10.3 (95% CI=8.2-12.6) months, respectively (log-rank P<0.0001), and the median overall survival was 13.8 (95% CI=10.6-18.1) months and 40.9 (95% CI=25.3-54.2) months, respectively (log-rank P<0.0001).

CONCLUSION

Platinum-free interval is a predictor of response and survival after second-line platinum-based chemotherapy in patients with recurrent endometrial cancer. The concept of "platinum sensitivity" could be applicable to recurrent endometrial cancer.

摘要

目的

“铂类药物敏感性”这一概念已广泛应用于复发性卵巢癌的治疗管理。本研究旨在评估这一概念在复发性子宫内膜癌中的适用性。

患者与方法

在这项多中心回顾性队列研究中,对 2005 年 1 月至 2009 年 12 月期间在复发时接受过一线含铂化疗且二线接受含铂化疗的复发性子宫内膜癌患者的临床资料进行了回顾性分析。

结果

共纳入 30 家中心的 262 例初治国际妇产科联盟(FIGO)分期为Ⅰ期(29 例)、Ⅱ期(23 例)、Ⅲ期(122 例)和Ⅳ期(88 例)的患者。共记录到子宫内膜样腺癌 153 例、浆液性腺癌 34 例、透明细胞腺癌 17 例、癌肉瘤 36 例和其他肿瘤 22 例。铂类药物无治疗间期<6 个月、6-11 个月、12-23 个月和≥24 个月的患者的缓解率分别为 25%、38%、61%和 65%。铂类药物无治疗间期<12 个月和≥12 个月的患者二线含铂化疗后的中位无进展生存期分别为 4.4(95%置信区间[CI]=3.7-5.8)个月和 10.3(95% CI=8.2-12.6)个月(对数秩检验 P<0.0001),中位总生存期分别为 13.8(95% CI=10.6-18.1)个月和 40.9(95% CI=25.3-54.2)个月(对数秩检验 P<0.0001)。

结论

铂类药物无治疗间期是复发性子宫内膜癌患者二线含铂化疗后反应和生存的预测因素。“铂类药物敏感性”这一概念可能适用于复发性子宫内膜癌。

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