Chen Wei-Chun, Huang Huei-Jean, Chang Ting-Chang, Chou Hung-Hsueh
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taiwan; Chang Gung University, College of Medicine, Taiwan.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taiwan; Chang Gung University, College of Medicine, Taiwan.
Taiwan J Obstet Gynecol. 2020 Jan;59(1):21-27. doi: 10.1016/j.tjog.2019.10.003.
To analyze the response to dose-dense chemotherapy of weekly paclitaxel and 3-weekly carboplatin in recurrent ovarian cancer, and to report results of literature review.
Patients accepted weekly paclitaxel 80 mg/m on day 1, 8, 15 and carboplatin on day1 at area under curve (AUC) 6 every 21 days were reviewed for the response rate, progression-free survival, overall survival, and toxicity during January 2012 to April 2016 in Chang Gung Memorial Hospital at Linkou, Taiwan.
Sixteen patients with recurrent ovarian cancer, including 1 platinum-resistant, 7 partially platinum-sensitive, and 8 platinum-sensitive, accepted a median of 6 cycles of chemotherapy (range 3-10). The overall response rate (ORR) and complete response (CR) rate were 93.8%, and 62.5%, respectively. The median PFS of all patients were 10.9 months (range 4.3-40.5). The median time to response (TTR) was 29.0 days (range 19.6-38.4). The median disease-free survival (DFS) after CR was 5.6 months (range 1.2-34.2). Grade 3 at least toxicity included anemia (6.3%), neutropenia (50%), and thrombocytopenia (18.8%). Twenty-nine articles on phase I, II, III, or retrospective studies of dose-dense chemotherapy with weekly paclitaxel were reviewed.
This is the first report using Japanese Gynecologic Oncology Group 3016 protocol, weekly paclitaxel and 3-weely carboplatin, on recurrent ovarian cancer. The current study showed high ORR and CR with tolerable toxicities. Our study suggested dose-dense chemotherapy with paclitaxel, especially combining carboplatin created high efficacy probably by anti-angiogenesis. However, consolidation or maintenance therapy is needed to prolong DFS.
分析复发性卵巢癌患者对每周一次紫杉醇和每三周一次卡铂的剂量密集化疗的反应，并报告文献综述结果。
回顾性分析2012年1月至2016年4月在台湾林口长庚纪念医院接受治疗的患者，这些患者在第1、8、15天接受每周一次的紫杉醇80mg/m²治疗，并每21天在第1天接受卡铂治疗，卡铂曲线下面积（AUC）为6。对其缓解率、无进展生存期、总生存期和毒性进行评估。
16例复发性卵巢癌患者，包括1例铂耐药、7例部分铂敏感和8例铂敏感患者，接受了中位数为6个周期的化疗（范围3 - 10）。总缓解率（ORR）和完全缓解（CR）率分别为93.8%和62.5%。所有患者的中位无进展生存期（PFS）为10.9个月（范围4.3 - 40.5）。中位缓解时间（TTR）为29.0天（范围19.6 - 38.4）。CR后的中位无病生存期（DFS）为5.6个月（范围1.2 - 34.2）。至少3级毒性包括贫血（6.3%）、中性粒细胞减少（50%）和血小板减少（18.8%）。回顾了29篇关于每周一次紫杉醇剂量密集化疗的I期、II期、III期或回顾性研究的文章。
这是首次使用日本妇科肿瘤学组3016方案，即每周一次紫杉醇和每三周一次卡铂治疗复发性卵巢癌的报告。当前研究显示出高ORR和CR，且毒性可耐受。我们的研究表明，紫杉醇剂量密集化疗，尤其是联合卡铂，可能通过抗血管生成产生高疗效。然而，需要巩固或维持治疗来延长DFS。
