Choi Hyun-Jin, Lee Yoo-Young, Choi Chel Hun, Kim Tae-Joong, Lee Jeong-Won, Bae Ji Hye, Bae Duk-Soo, Kim Byoung-Gie
Department of Obstetrics and Gynecology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Curr Probl Cancer. 2020 Oct;44(5):100557. doi: 10.1016/j.currproblcancer.2020.100557. Epub 2020 Feb 12.
The effectiveness of paclitaxel-cisplatin-ifosfamide triplet regimen (TIP) was reported to be superior to that of paclitaxel-cisplatin doublet. However, the efficacy of paclitaxel-cisplatin-bevacizumab triplet (TPA) and TIP has not been compared. Here, we compared the efficacy and safety of TIP and TPA in patients with metastatic, recurrent, or persistent cervical cancer.
We retrospectively reviewed the medical records of patients with recurrent, persistent, or metastatic cervical cancer who were at the Samsung Medical Center, Seoul, Korea between January 2005 and September 2018. Of the 161 patients included in the study, 92 had received TIP and 71 had received TPA. For the study, we compared the response rates, progression-free survival (PFS), overall survival (OS), and safety in the 2 treatment groups.
The response rates of patients who received TIP and TPA were comparable (64.1% vs 73.2%, P = 0.239). Histology (squamous vs nonsquamous) was the only prognostic factor that affected the response to therapy (odds ratio, 0.259; 95% confidence interval [CI], 0.119-0.562; P = 0.001). The PFS after TIP and TPA treatment was similar: 12.0 months (95%CI, 10.26-13.74) vs 11.5 months (95%CI, 10.18-12.83), respectively. In a Cox proportional hazard model, objective response to therapies was the only independent prognostic factor for both PFS and OS. However, different types of therapy (TIP vs TPA) did not affect the oncological outcomes for either PFS or OS. Although hematologic toxicity was significantly higher in the TIP-treated group than in the TPA-treated group, both regimens were safe and well-tolerated.
The effectiveness and safety of TIP was comparable to TPA in terms of response rates, survival, and adverse effects. TIP could be an effective alternative in the treatment of cervical cancer when TPA is contraindicated or unaffordable.
据报道，紫杉醇-顺铂-异环磷酰胺三联方案（TIP）的疗效优于紫杉醇-顺铂双联方案。然而，紫杉醇-顺铂-贝伐单抗三联方案（TPA）与TIP的疗效尚未进行比较。在此，我们比较了TIP和TPA在转移性、复发性或持续性宫颈癌患者中的疗效和安全性。
我们回顾性分析了2005年1月至2018年9月期间在韩国首尔三星医疗中心就诊的复发性、持续性或转移性宫颈癌患者的病历。在纳入研究的161例患者中，92例接受了TIP治疗，71例接受了TPA治疗。在本研究中，我们比较了两个治疗组的缓解率、无进展生存期（PFS）、总生存期（OS）和安全性。
接受TIP和TPA治疗的患者缓解率相当（64.1%对73.2%，P = 0.239）。组织学类型（鳞状 vs 非鳞状）是影响治疗反应的唯一预后因素（比值比，0.259；95%置信区间[CI]，0.119 - 0.562；P = 0.001）。TIP和TPA治疗后的PFS相似：分别为12.0个月（95%CI，10.26 - 13.74）和11.5个月（95%CI，10.18 - 12.83）。在Cox比例风险模型中, 治疗后的客观缓解是PFS和OS的唯一独立预后因素。然而，不同类型的治疗（TIP vs TPA）对PFS或OS的肿瘤学结局均无影响。尽管TIP治疗组的血液学毒性显著高于TPA治疗组，但两种方案均安全且耐受性良好。
在缓解率、生存率和不良反应方面，TIP的有效性和安全性与TPA相当。当TPA禁忌或无法使用时，TIP可能是治疗宫颈癌的有效替代方案。
