Boraska Jelavić Tihana, Boban Toni, Brčić Luka, Vrdoljak Eduard
aDepartment of Oncology, University Hospital Split bDepartment of Medical Biology, School of Medicine, University of Split, Split, Croatia.
Anticancer Drugs. 2017 Sep;28(8):922-927. doi: 10.1097/CAD.0000000000000538.
The aims of this study were to investigate a clinical observation that patients with epithelial ovarian cancer treated with first-line platinum-paclitaxel chemotherapy combination (TP) develop macrocytosis and to explore the possible predictive role of macrocytosis in response rate, progression-free survival (PFS), and overall survival. A retrospective analysis of laboratory and clinical data on 184 consecutive ovarian cancer patients treated with first-line TP chemotherapy in a single oncology center from 2004 to 2015 was carried out. Macrocytosis was defined as an increase in mean corpuscular volume of peripheral red blood cells above 97.2 fl during the treatment and/or 30 days after the last chemotherapy cycle. One hundred and forty-one patients were treated with a conventional 3-weekly TP schedule, whereas 43 patients were treated with a dose-dense schedule. Macrocytosis was induced in 35% of patients overall. It was induced significantly more often in patients treated with the dose-dense schedule than in those treated with the 3-weekly schedule (67 vs. 26%, P=1.29×10). Macrocytosis did not correlate with PFS and overall survival in the overall patient population, nor in patients treated with the 3-weekly schedule. It correlated with PFS (hazard ratio=0.42, 95% confidence interval=0.18-0.94, P=0.036) and objective response on therapy in patients treated with the dose-dense schedule (P=0.0285). Dose-dense TP chemotherapy induces macrocytosis significantly more often than does a 3-weekly schedule in ovarian cancer patients. In patients treated with a dose-dense schedule, macrocytosis can potentially be predictive for longer PFS and better response rate. This finding needs further confirmation, preferentially in a prospective study.
本研究的目的是调查一项临床观察结果，即接受一线铂类-紫杉醇化疗联合方案（TP）治疗的上皮性卵巢癌患者会出现大细胞性贫血，并探讨大细胞性贫血在缓解率、无进展生存期（PFS）和总生存期方面可能的预测作用。对2004年至2015年在单个肿瘤中心接受一线TP化疗的184例连续卵巢癌患者的实验室和临床数据进行了回顾性分析。大细胞性贫血定义为治疗期间和/或最后一个化疗周期后30天外周红细胞平均体积增加至97.2 fl以上。141例患者接受传统的每3周一次的TP方案治疗，而43例患者接受剂量密集方案治疗。总体上35%的患者出现了大细胞性贫血。接受剂量密集方案治疗的患者出现大细胞性贫血的频率明显高于接受每3周一次方案治疗的患者（67%对26%，P=1.29×10）。在总体患者人群中，以及在接受每3周一次方案治疗的患者中，大细胞性贫血与PFS和总生存期均无相关性。在接受剂量密集方案治疗的患者中，大细胞性贫血与PFS（风险比=0.42，95%置信区间=0.18-0.94，P=0.036）和治疗的客观缓解率相关（P=0.0285）。在卵巢癌患者中，剂量密集的TP化疗比每3周一次的方案更常引起大细胞性贫血。在接受剂量密集方案治疗的患者中，大细胞性贫血可能预示着更长的PFS和更好的缓解率。这一发现需要进一步证实，最好是在前瞻性研究中。
