Division of Gynecologic Oncology, New York University School of Medicine, 240 East 38th Street, New York, NY, USA.
Division of Medical Oncology, New York University School of Medicine, 160 East 34th Street, New York, NY, USA.
Cancer Chemother Pharmacol. 2018 Jul;82(1):55-63. doi: 10.1007/s00280-018-3591-y. Epub 2018 Apr 27.
To evaluate the outcomes of intraperitoneal chemotherapy (IP) compared with those of intravenous chemotherapy (IV) in patients with advanced ovarian cancer after neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) or primary debulking surgery (PDS).
Patients with advanced epithelial ovarian carcinoma treated with PDS or NACT and IDS from 2006 to 2015 were identified. Comparative statistics were used to evaluate covariates, and survival rates were calculated using the Kaplan-Meier method and compared with log-rank tests.
Sixty-six patients received NACT followed by IDS with residual disease of ≤ 1 cm; 42 of these patients (63.6%) received IP therapy; and 24 patients (36.3%) had IV therapy only after IDS. The median progression-free survival (PFS) was 16.0 months in the IP group and 13.5 months in the IV group (p = 0.13). The estimated median overall survival (OS) was 64.0 months with IP and 50.0 months with IV (p = 0.44). During the same study period, 149 patients underwent optimal PDS after which 93 patients (62.4%) received IP and 56 patients (37.6%) were given IV chemotherapy. Patients after IP demonstrated improved survival outcomes when compared to patients after IV therapy. The median PFS was 28.0 months after IP and 16.5 months after IV (p = 0.0006), and the median OS was not reached for IP and 50.0 months after IV (p < 0.0001).
Although IP chemotherapy after PDS is associated with improved survival, IP therapy after NACT and IDS, despite high rates of completion, may not have the same degree of survival advantage over IV therapy.
评估新辅助化疗（NACT）和间隔减瘤术（IDS）或直接减瘤术（PDS）后接受腹腔内化疗（IP）与静脉化疗（IV）治疗的晚期卵巢癌患者的结局。
回顾性分析 2006 年至 2015 年间接受 PDS 或 NACT 和 IDS 治疗的晚期上皮性卵巢癌患者。采用比较统计学方法评估协变量，Kaplan-Meier 法计算生存率，并采用对数秩检验比较。
66 例患者接受 NACT 后 IDS 残留病灶≤1cm，其中 42 例（63.6%）接受 IP 治疗，24 例（36.3%）仅在 IDS 后接受 IV 治疗。IP 组无进展生存期（PFS）中位数为 16.0 个月，IV 组为 13.5 个月（p=0.13）。IP 组总生存期（OS）中位数为 64.0 个月，IV 组为 50.0 个月（p=0.44）。在同一研究期间，149 例患者接受了最佳 PDS，其中 93 例（62.4%）接受 IP 治疗，56 例（37.6%）接受 IV 化疗。与 IV 治疗相比，接受 IP 治疗的患者生存结局得到改善。IP 组中位 PFS 为 28.0 个月，IV 组为 16.5 个月（p=0.0006），IP 组中位 OS 未达到，IV 组为 50.0 个月（p<0.0001）。
尽管 PDS 后 IP 化疗与生存改善相关，但 NACT 和 IDS 后 IP 治疗，尽管完成率较高，但与 IV 治疗相比，可能没有相同程度的生存优势。
