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[在秘鲁国家肿瘤疾病研究所,采用剂量密集型紫杉醇和卡铂治疗晚期卵巢癌后进行间隔期手术的最佳肿瘤细胞减灭术]

[Optimal cytoreduction in advanced ovarian cancer treated with dose-dense paclitaxel and carboplatin followed by interval surgery at the Peruvian National Institute of Neoplastic Diseases].

作者信息

Alcarraz Cindy, Muñiz Johana, Mas Luis, Olivera Mivael, Morante Zaida, Alvarez Manuel, Mantilla Raul, Araujo Jhajaira, Pinto Joseph

机构信息

Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú.

Oncosalud, AUNA. Lima, Perú.

出版信息

Rev Peru Med Exp Salud Publica. 2018 Jan-Mar;35(1):46-54. doi: 10.17843/rpmesp.2018.351.3599.

Abstract

OBJECTIVES

To determine the rate of optimal cytoreduction in patients with advanced ovarian cancer who received neoadjuvant chemotherapy with dose-dense carboplatin and paclitaxel followed by interval debulking surgery (IDS).

MATERIALS AND METHODS

A retrospective study of a series of cases of Peruvian women treated with neoadjuvant chemotherapy with carboplatin (6 AUC mg/mL/min) and paclitaxel (80 mg/m2 weekly) followed by IDS, at the National Institute of Neoplastic Diseases during the 2010-2014 period.

RESULTS

The 41 patients who made it to the interval surgery had a median age of 59 years (range: 47-73 years). In 37 (90.2%) patients, high-grade serous adenocarcinoma histology was reported. Thirty-four (82.9%) achieved optimal cytoreduction and five (14.7%), a complete pathological response. Progression-free survival at one year and two years was 74.7% and 51.8%, respectively. Overall survival at one year and two years was 85.2% and 71.4%, respectively. The risk of progression and death was greater in patients without optimal cytoreduction and in patients with postsurgery levels of carcinoembryonic antigen 125 > 30 U/mL.

CONCLUSIONS

Neoadjuvant therapy with dose-dense carboplatin and paclitaxel achieved an elevated frequency of optimal cytoreduction. The post-surgery levels of carcinoembryonic antigen 125 and optimal cytoreduction were independent factors of progression-free survival and overall survival.

摘要

目的

确定接受剂量密集型卡铂和紫杉醇新辅助化疗后行间歇性肿瘤细胞减灭术(IDS)的晚期卵巢癌患者的最佳肿瘤细胞减灭率。

材料与方法

对2010年至2014年期间在国家肿瘤疾病研究所接受卡铂(6AUCmg/mL/min)和紫杉醇(80mg/m²每周)新辅助化疗后行IDS的一系列秘鲁女性病例进行回顾性研究。

结果

41例接受间歇性手术的患者中位年龄为59岁(范围:47 - 73岁)。37例(90.2%)患者报告为高级别浆液性腺癌组织学类型。34例(82.9%)实现了最佳肿瘤细胞减灭,5例(14.7%)达到完全病理缓解。1年和2年无进展生存率分别为74.7%和51.8%。1年和2年总生存率分别为85.2%和71.4%。未实现最佳肿瘤细胞减灭的患者以及术后癌胚抗原125水平>30U/mL的患者进展和死亡风险更高。

结论

剂量密集型卡铂和紫杉醇新辅助治疗实现了较高频率的最佳肿瘤细胞减灭。术后癌胚抗原125水平和最佳肿瘤细胞减灭是无进展生存和总生存的独立因素。

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