细胞减灭术联合腹腔热灌注化疗治疗晚期/复发性上皮性卵巢癌：来自前瞻性建立的数据库的回顾性研究结果。
Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy to Treat Advanced/Recurrent Epithelial Ovarian Cancer: Results from a Retrospective Study on Prospectively Established Database.
机构信息
Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan, 430071, P. R. China; Department of Gastrointestinal Surgery, Enshi Autonomous Prefecture Hospital, Enshi, Hubei, 445000, P. R. China.
Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan, 430071, P. R. China.
出版信息
Transl Oncol. 2016 Apr;9(2):130-138. doi: 10.1016/j.tranon.2016.02.002.
BACKGROUND
Despite the best standard treatment, optimal cytoreductive surgery (CRS) and platinum/taxane-based chemotherapy, prognosis of advanced epithelial ovarian carcinoma (EOC) remains poor. Recently, CRS plus hyperthermic intraperitoneal chemotherapy (HIPEC) has been developed to treat peritoneal carcinomatosis (PC). This study was to evaluate the efficacy and safety of CRS+HIPEC to treat PC from advanced/recurrent EOC.
METHODS
Forty-six PC patients from advanced EOC (group A) or recurrent EOC (group B) were treated by 50 CRS+HIPEC procedures. The primary endpoints were progression-free survival (PFS) and overall survival (OS); the secondary endpoints were safety profiles.
RESULTS
The median OS was 74.0 months [95% confidence interval (CI) 8.5-139.5] for group A versus 57.5 months (95% CI 29.8-85.2) for group B (P = .68). The median PFS was not reached for group A versus 8.5 months (95% CI 0-17.5) for group B (P = .034). Better median OS correlated with peritoneal cancer index (PCI) < 20 (76.6 months for PCI ≤ 20 group vs 38.5 months for PCI > 20 group, P = .01), complete cyroreduction (residual disease ≤ 2.5 mm) [79.5 months for completeness of cytoreduction (CC) score 0-1 vs 24.3 months for CC 2-3, P = .00], and sensitivity to platinum (65.3 months for platinum-sensitive group vs 20.0 for platinum-resistant group, P = .05). Serious adverse events occurred in five patients (10.0%). Multivariate analysis identified CC score as the only independent factor for better survival.
CONCLUSION
For advanced/recurrent EOC, CRS+HIPEC could improve OS with acceptable safety.
背景
尽管采用了最佳标准治疗、最佳减瘤手术（CRS）和铂类/紫杉烷类化疗，晚期上皮性卵巢癌（EOC）的预后仍然较差。最近，CRS 加腹腔内热灌注化疗（HIPEC）已被开发用于治疗腹膜癌病（PC）。本研究旨在评估 CRS+HIPEC 治疗晚期/复发性 EOC 腹膜转移患者的疗效和安全性。
方法
46 例来自晚期 EOC（A 组）或复发性 EOC（B 组）的 PC 患者接受了 50 次 CRS+HIPEC 治疗。主要终点为无进展生存期（PFS）和总生存期（OS）；次要终点为安全性特征。
结果
A 组的中位 OS 为 74.0 个月[95%置信区间（CI）8.5-139.5]，B 组为 57.5 个月（95%CI 29.8-85.2）（P=.68）。A 组中位 PFS未达到，B 组为 8.5 个月（95%CI 0-17.5）（P=.034）。更好的中位 OS 与腹膜癌指数（PCI）<20 相关（PCI≤20 组为 76.6 个月，PCI>20 组为 38.5 个月，P=.01），完全肿瘤减灭术（残余肿瘤≤2.5mm）[CC 评分 0-1 组为 79.5 个月，CC 评分 2-3 组为 24.3 个月，P=.00]和对铂类的敏感性（铂类敏感组为 65.3 个月，铂类耐药组为 20.0 个月，P=.05）。5 例患者发生严重不良事件（10.0%）。多因素分析确定 CC 评分为生存的唯一独立因素。
结论
对于晚期/复发性 EOC，CRS+HIPEC 可提高 OS 并具有可接受的安全性。
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