Yoshihama Tomoko, Nomura Hiroyuki, Iwasa Naomi, Kataoka Fumio, Hashimoto Shiho, Nanki Yoshiko, Hirano Takuro, Makabe Takeshi, Sakai Kensuke, Yamagami Wataru, Hirasawa Akira, Aoki Daisuke
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
Jpn J Clin Oncol. 2017 Nov 1;47(11):1019-1023. doi: 10.1093/jjco/hyx118.
Interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) is currently one of the preferred treatment options for advanced ovarian, fallopian tube or peritoneal cancer. This study was conducted to evaluate the clinical efficacy and safety of dose-dense paclitaxel plus carboplatin therapy (ddTC therapy) as NAC for these cancers.
A retrospective study was conducted in 25 patients with Stage III/IV ovarian, fallopian tube or peritoneal cancer who received ddTC therapy as NAC. For ddTC therapy, paclitaxel (80 mg/m2) was administered intravenously on Days 1, 8 and 15 and carboplatin (AUC 6.0 mg/ml × min) was administered intravenously on Day 1 every 3 weeks. IDS was performed after three cycles of ddTC therapy, and ddTC therapy was also continued after surgery.
With ddTC therapy as NAC, the response rate was 92% and disease progression did not occur in any patient. Grade 4 hematologic toxicity and ≥Grade 3 non-hematologic toxicity both occurred in 8% of the patients, but no patient discontinued NAC because of adverse events. When IDS was performed, the complete surgery rate was 64% and the optimal surgery rate was 96%. ≥Grade 3 perioperative complications occurred in 16% of the patients, but there were no perioperative deaths. Median overall survival was 35.7 months and median progression-free survival was 17.7 months.
This study showed that ddTC therapy was considerably effective and tolerable as NAC. The complete surgery rate was high with IDS, and perioperative complications were acceptable.
新辅助化疗（NAC）后进行间歇性肿瘤细胞减灭术（IDS）是目前晚期卵巢癌、输卵管癌或腹膜癌的首选治疗方案之一。本研究旨在评估剂量密集型紫杉醇联合卡铂疗法（ddTC疗法）作为这些癌症的NAC的临床疗效和安全性。
对25例接受ddTC疗法作为NAC的III/IV期卵巢癌、输卵管癌或腹膜癌患者进行了一项回顾性研究。对于ddTC疗法，紫杉醇（80mg/m²）在第1、8和15天静脉给药，卡铂（AUC 6.0mg/ml×min）每3周在第1天静脉给药。在ddTC疗法三个周期后进行IDS，术后也继续进行ddTC疗法。
以ddTC疗法作为NAC，缓解率为92%，无患者出现疾病进展。4级血液学毒性和≥3级非血液学毒性均发生在8%的患者中，但没有患者因不良事件而停止NAC。进行IDS时，完整手术率为64%，最佳手术率为96%。16%的患者出现≥3级围手术期并发症，但无围手术期死亡。中位总生存期为35.7个月，中位无进展生存期为17.7个月。
本研究表明，ddTC疗法作为NAC具有显著疗效且耐受性良好。IDS的完整手术率高，围手术期并发症可接受。
