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可测量的成年卵巢颗粒细胞瘤患者激素治疗反应的评估。

Evaluation of response to hormone therapy in patients with measurable adult granulosa cell tumors of the ovary.

作者信息

van Meurs Hannah S, van der Velden Jacobus, Buist Marrije R, van Driel Willemien J, Kenter Gemma G, van Lonkhuijzen Luc R C W

机构信息

Department of Gynecology, Center for Gynecologic Oncology Amsterdam, Academic Medical Center, Amsterdam, The Netherlands.

Department of Gynecology, Center for Gynecologic Oncology Amsterdam, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

出版信息

Acta Obstet Gynecol Scand. 2015 Nov;94(11):1269-75. doi: 10.1111/aogs.12720. Epub 2015 Sep 15.

Abstract

INTRODUCTION

The aim of this study was to retrospectively determine the objective response rate to hormone therapy (HT) for patients with a measurable adult granulosa cell tumor (GCT) of the ovary in a consecutive series of patients.

MATERIAL AND METHODS

All patients with an adult GCT who were treated with HT [steroidal progestins, selective estrogen receptor modulators, aromatase inhibitors and gonadotropin-releasing hormone agonists] within three referral hospitals were identified and their records were screened for HT administration. The main outcome measure was the objective response rate to HT.

RESULTS

We identified 127 patients with an adult GCT, of whom 81 (64%) had a recurrence. Twenty-five of these patients (20%) were treated with hormones, of whom 22 had measurable disease at the start of their treatment, i.e. a tumor of more than 1 cm in diameter as seen on imaging, either as a recurrence or as residual disease. The pooled objective response rate, defined as the proportion of patients whose best overall response to hormone therapy was either complete response or partial response to HT, was 18% (4/22) (95% confidence interval 6-41%). In one patient (4.5%) a complete response and in three (14%) a partial response was described. Fourteen patients (64%) had stable disease and in four patients (18%) disease was progressive.

CONCLUSIONS

Although several case reports described good responses to HT in patients with a GCT, we found a response in only four of 22 patients in this relatively large consecutive series of patients.

摘要

引言

本研究的目的是回顾性确定在一系列连续的成年卵巢颗粒细胞瘤(GCT)患者中,激素治疗(HT)的客观缓解率。

材料与方法

确定了在三家转诊医院接受HT[甾体类孕激素、选择性雌激素受体调节剂、芳香化酶抑制剂和促性腺激素释放激素激动剂]治疗的所有成年GCT患者,并筛选其HT给药记录。主要结局指标是HT的客观缓解率。

结果

我们确定了127例成年GCT患者,其中81例(64%)复发。这些患者中有25例(20%)接受了激素治疗,其中22例在治疗开始时具有可测量的疾病,即影像学上可见直径超过1 cm的肿瘤,无论是复发还是残留疾病。汇总的客观缓解率定义为对激素治疗的最佳总体反应为完全缓解或部分缓解的患者比例,为18%(4/22)(95%置信区间6-41%)。描述了1例患者(4.5%)完全缓解,3例(14%)部分缓解。14例患者(64%)疾病稳定,4例患者(18%)疾病进展。

结论

尽管有几例病例报告描述了GCT患者对HT有良好反应,但在这一相对较大的连续系列患者中,我们发现22例患者中只有4例有反应。

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