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改良剂量密集型紫杉醇治疗复发性宫颈癌的疗效

Efficacy of Modified Dose-dense Paclitaxel in Recurrent Cervical Cancer.

作者信息

Machida Hiroko, Moeini Aida, Ciccone Marcia A, Mostofizadeh Sayedamin, Takiuchi Tsuyoshi, Brunette Laurie L, Roman Lynda D, Matsuo Koji

机构信息

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology.

Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA.

出版信息

Am J Clin Oncol. 2018 Sep;41(9):851-860. doi: 10.1097/COC.0000000000000394.

Abstract

OBJECTIVE

To examine survival outcomes of women with recurrent cervical cancer who received salvage chemotherapy with modified dose-dense paclitaxel (MDDP) monotherapy (paclitaxel 80 mg/m, administered on day 1, 8, and 15 without day 22).

MATERIALS AND METHODS

A retrospective study was conducted to evaluate cause-specific survival after the first recurrence (SAR) of women with recurrent cervical cancer diagnosed between 2006 and 2014. Pooled analyses were performed to examine SAR in women who received MDDP monotherapy (n=17) for any treatment line, compared with those who received salvage chemotherapy with paclitaxel-doublet (n=18) and nonpaclitaxel regimens (n=52).

RESULTS

In the whole cohort, median SAR was 13.7 months including 63 (72.4%) events. MDDP monotherapy regimen was most commonly used in the second-line setting (35.3%) followed by the third/fourth lines (both, 23.5%). Among the women who received MDDP regimen, there were 6 (35.3%) women who received ≥6 cycles; there was 1 (5.9%) women who discontinued the regimen due to adverse effects (grade 3 transaminitis); regimen postponement was seen in 2 (1.4%) of 140 total cycles; and the response rate after the sixth cycle of this regimen was 29.4% (1 complete and 4 partial responses). On univariate analysis, MDDP usage had the highest 2-year SAR rate (MDDP 54.1%, paclitaxel-doublet 43.6%, and nonpaclitaxel regimens 28.1%; Ptrend=0.044). On multivariate analysis, MDDP monotherapy remained an independent prognostic factor for improved SAR compared with the nonpaclitaxel regimen (adjusted-hazard ratio, 0.50; 95% confidence interval, 0.26-0.95; P=0.036).

CONCLUSION

Our results suggested that MDDP monotherapy is a tolerable and relatively effective regimen for recurrent cervical cancer.

摘要

目的

研究接受改良剂量密集型紫杉醇(MDDP)单药挽救化疗(紫杉醇80mg/m²,于第1、8和15天给药,无第22天给药)的复发性宫颈癌女性的生存结局。

材料与方法

进行一项回顾性研究,以评估2006年至2014年间诊断为复发性宫颈癌的女性首次复发后的特定病因生存率(SAR)。对接受MDDP单药治疗(n = 17)用于任何治疗线的女性与接受含紫杉醇双药挽救化疗(n = 18)和非紫杉醇方案(n = 52)的女性的SAR进行汇总分析。

结果

在整个队列中,中位SAR为13.7个月,包括63例(72.4%)事件。MDDP单药治疗方案最常用于二线治疗(35.3%),其次是三线/四线治疗(均为23.5%)。在接受MDDP方案的女性中,有6例(35.3%)接受了≥6个周期的治疗;有1例(5.9%)女性因不良反应(3级转氨酶升高)停止治疗;在总共140个周期中有2例(1.4%)出现治疗延迟;该方案第六周期后的缓解率为29.4%(1例完全缓解和4例部分缓解)。单因素分析显示,使用MDDP的2年SAR率最高(MDDP为54.1%,含紫杉醇双药为43.6%,非紫杉醇方案为28.1%;Ptrend = 0.044)。多因素分析显示,与非紫杉醇方案相比,MDDP单药治疗仍然是改善SAR的独立预后因素(调整后风险比,0.50;95%置信区间,0.26 - 0.95;P = 0.036)。

结论

我们的结果表明,MDDP单药治疗是复发性宫颈癌一种可耐受且相对有效的方案。

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本文引用的文献

1
Significance of venous thromboembolism in women with cervical cancer.静脉血栓栓塞在宫颈癌女性患者中的意义。
Gynecol Oncol. 2016 Sep;142(3):405-12. doi: 10.1016/j.ygyno.2016.06.012. Epub 2016 Jun 25.
3
Cancer statistics, 2016.癌症统计数据,2016 年。
CA Cancer J Clin. 2016 Jan-Feb;66(1):7-30. doi: 10.3322/caac.21332. Epub 2016 Jan 7.

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