Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, United States.
Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, United States.
J Gynecol Obstet Hum Reprod. 2021 May;50(5):101844. doi: 10.1016/j.jogoh.2020.101844. Epub 2020 Jun 23.
Hyperthermic intraperitoneal chemotherapy following cytoreductive surgery (CRS) is a treatment strategy that has been evaluated in recurrent ovarian cancer. The aim of this study was to examine if survival was similar regardless of platinum sensitivity.
A retrospective study of women with recurrent platinum sensitive or resisteant epithelial ovarian cancer who were treated with cytoreductive surgery (CRS) and HIPEC between the years 2010-2018 was performed. Recurrence free (RFS) and overall survival (OS) were calculated using the Kaplan-Meier method.
Thirty-five (72.9 %) were platinum sensitive (PS) and 13 (27.1 %) were platinum resistant (PR). The complete cytoreduction (R0) rate was higher in the PS patients as compared to PR (85.7 % vs 53.8 %; p = 0.017). Median follow-up was 16.9 (range, 11.7-34.5) months. The median recurrence free survival in the patients who had a R0 resection was 22.3 months in PS and 11.1 months in PR patients (p = 0.017), respectively. Median overall survival was 26.9 months in the PR patients, while it had not been reached in the PS patients. In the patients with PS recurrence, the mean treatment free interval (TFI) prior to HIPEC was 1.6 years and following HIPEC, 40 % of those patients were recurrence free at 2 years. In the patients with PR recurrence, the mean TFI prior to HIPEC was 4.6 months and following HIPEC, 61.5 % of those patients had a longer TFI, with a mean increase of 10.1 months.
Although surgery is not considered standard treatment in PR ovarian cancer, in carefully selected patients, surgery with HIPEC could extend the treatment-free interval.
细胞减灭术（CRS）后腹腔内热化疗（HIPEC）是一种已在复发性卵巢癌中进行评估的治疗策略。本研究的目的是检查生存是否与铂类药物敏感性无关。
对 2010 年至 2018 年间接受细胞减灭术（CRS）和 HIPEC 治疗的复发性铂类敏感或耐药上皮性卵巢癌女性进行回顾性研究。采用 Kaplan-Meier 法计算无复发生存（RFS）和总生存（OS）。
35 例（72.9%）为铂类敏感（PS），13 例（27.1%）为铂类耐药（PR）。PS 患者的完全肿瘤减灭（R0）率高于 PR 患者（85.7%对 53.8%；p=0.017）。中位随访时间为 16.9 个月（范围 11.7-34.5）。R0 切除患者的中位无复发生存期分别为 PS 患者 22.3 个月和 PR 患者 11.1 个月（p=0.017）。PR 患者的中位总生存期为 26.9 个月，而 PS 患者尚未达到。在 PS 复发患者中，HIPEC 前的平均无治疗间隔（TFI）为 1.6 年，HIPEC 后，40%的患者在 2 年内无复发。在 PR 复发患者中，HIPEC 前的平均 TFI 为 4.6 个月，HIPEC 后，61.5%的患者 TFI 延长，平均增加 10.1 个月。
尽管在 PR 卵巢癌中手术不被认为是标准治疗，但在精心选择的患者中，手术联合 HIPEC 可延长无治疗间隔。
