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散发性和胚系BRCA1相关卵巢癌患者治疗效果的比较。

Comparison of effectiveness of treatment of patients with sporadic and germline BRCA1-related ovarian cancer.

作者信息

Szatkowski Wiktor, Muzykiewicz Konrad, Jasiówka Marek, Karolewski Kazimierz, Kojs Zbigiew, Klimek Małgorzata, Blecharz Paweł

机构信息

Department of Gynecologic Oncology, Centre of Oncology, M. Sklodowska-Curie Memorial Institute, Cracow Department, Cracow, Poland.

出版信息

Ginekol Pol. 2016;87(6):422-5. doi: 10.5603/GP.2016.0019.

Abstract

OBJECTIVES

Numerous reports suggest that the clinical course of ovarian cancer (OC) in BRCA, including BRCA1, mutation carriers (BRCA1-OC) is different than in patients with sporadic ovarian cancer (SOC). Most of the authors indicate more fa-vourable treatment results in patients with BRCA1-OC. The aim of the study was to compare the effectiveness of treatment of patients with advanced-stage (FIGO III/IV) SOC and BRCA1-OC.

MATERIAL AND METHODS

Between 2004 and 2009, 957 OC patients were treated in Cracow Branch of Cancer Center, M. Sklodowska-Curie Memorial Institute, Poland. Germline BRCA1 mutation was found in 66 patients. To compare the effective-ness of treatment, the group of 47 advanced-stage BRCA1-OC patients was matched with the group of 47 advanced-stage SOC patients. Pairs of patients were matched in terms of the most important prognostic factors, i.e. stages according to FIGO, primary cytoreduction extent, tumour histologic subtype and grade, as well as year of diagnosis and treatment.

RESULTS

The 5-year overall survival rate was 42.9% for BRCA1-OC patients and 34.3% for SOC patients (p = 0.354). Mean time to progression was 22.7 and 14.5 months for BRCA1-OC and SOC group, respectively (p = 0.05). Complete response to pri-mary surgery and first line chemotherapy was obtained in 42.5% and 37.9% of cases, respectively; the difference, however, did not reach the statistical significance.

CONCLUSIONS

Results of combined treatment in the group of BRCA1-related OC patients seem to be better than in the group of sporadic ovarian cancer patients.

摘要

目的

众多报告表明,携带BRCA(包括BRCA1)基因突变的卵巢癌(OC)患者(BRCA1-OC)的临床病程与散发性卵巢癌(SOC)患者不同。大多数作者指出,BRCA1-OC患者的治疗效果更佳。本研究的目的是比较晚期(国际妇产科联盟(FIGO)III/IV期)SOC和BRCA1-OC患者的治疗效果。

材料与方法

2004年至2009年期间,波兰克拉科夫市玛丽亚·斯克洛多夫斯卡-居里纪念肿瘤中心癌症中心分院对957例OC患者进行了治疗。66例患者检测到胚系BRCA1突变。为比较治疗效果,将47例晚期BRCA1-OC患者与47例晚期SOC患者进行配对。根据最重要的预后因素对患者进行配对,即FIGO分期、初次肿瘤细胞减灭术范围、肿瘤组织学亚型和分级,以及诊断和治疗年份。

结果

BRCA1-OC患者的5年总生存率为42.9%,SOC患者为34.3%(p = 0.354)。BRCA1-OC组和SOC组的平均进展时间分别为22.7个月和14.5个月(p = 0.05)。初次手术和一线化疗的完全缓解率分别为42.5%和37.9%;然而,差异未达到统计学意义。

结论

BRCA1相关OC患者联合治疗的效果似乎优于散发性卵巢癌患者。

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