Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan.
Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Cancer Chemother Pharmacol. 2019 Jul;84(1):33-39. doi: 10.1007/s00280-019-03834-1. Epub 2019 Apr 13.
BACKGROUND/OBJECTIVE: Platinum-refractory or -resistant ovarian cancer (PRROC) is associated with poor prognosis and low response to further chemotherapy. We investigated predictors of effectiveness of following treatments for PRROC.
We included 380 patients diagnosed with stage I-IV ovarian, fallopian tube, or primary peritoneal cancer, who were treated at the National Cancer Center Hospital in Japan from January 2007 to December 2014 and recurred after initial treatment, who had a platinum-refractory or -resistant relapses and received chemotherapy, in this single-center, retrospective study. We investigated factors related to response to following treatment, and to progression-free survival (PFS).
Among 183 patients (48%) who suffered recurrences, 62 (34%) developed PRROC after chemotherapy. In multivariate analysis, platinum-free interval (PFI) < 3 months was independently associated with progressive disease (odds ratio [OR] 6.043, 95% confidence interval [CI] 1.485-24.595, P = 0.012). Median PFS was 139 days (95% CI 19.4-258) among patients with PFI > 3 months, but was 57 days (95% CI 34.7-79.2) among those with PFI < 3 months. In multivariate analysis, two factors, performance status (PS) 1-2 (HR 1.915, 95% CI 1.074-3.415, P = 0.028) and PFI < 3 months (HR 1.943, 95% CI 1.109-3.403, P = 0.02), were independently associated with worse PFS.
PS 1-2 and PFI < 3 months were significant predictors of poor response to following treatment for PRROC. Risks and benefits of treatment should be frankly discussed with patients who have these characteristics.
背景/目的：铂耐药或铂难治性卵巢癌（PRROC）与预后不良和对进一步化疗反应低有关。我们研究了预测 PRROC 后续治疗效果的因素。
我们纳入了 380 名在日本国家癌症中心医院接受治疗的 I-IV 期卵巢、输卵管或原发性腹膜癌患者，这些患者在 2007 年 1 月至 2014 年 12 月期间接受初始治疗后复发，对铂类药物耐药或难治性复发，并接受化疗，这是一项单中心回顾性研究。我们研究了与后续治疗反应和无进展生存期（PFS）相关的因素。
在 183 名（48%）复发的患者中，有 62 名（34%）在化疗后发生 PRROC。多变量分析显示，无铂间期（PFI）<3 个月与疾病进展独立相关（优势比[OR] 6.043，95%置信区间[CI] 1.485-24.595，P=0.012）。PFI>3 个月的患者中位 PFS 为 139 天（95%CI 19.4-258），而 PFI<3 个月的患者中位 PFS 为 57 天（95%CI 34.7-79.2）。多变量分析显示，体能状态（PS）1-2（HR 1.915，95%CI 1.074-3.415，P=0.028）和 PFI<3 个月（HR 1.943，95%CI 1.109-3.403，P=0.02）是与较差 PFS 相关的两个独立因素。
PS 1-2 和 PFI<3 个月是 PRROC 对后续治疗反应不佳的显著预测因素。具有这些特征的患者应坦率地讨论治疗的风险和获益。
