Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Oncologist. 2021 Jan;26(1):30-39. doi: 10.1634/theoncologist.2020-0196. Epub 2020 Aug 12.
Conventional first-line combination therapy for ovarian cancer comprises 6 cycles of adjuvant or neoadjuvant carboplatin (AUC5-6) with paclitaxel (175 mg/m ) every 3 weeks (PC-3W). Weekly scheduling of paclitaxel may maximize its antiangiogenic effect and reduce adverse effects. We compared the efficacy and safety of PC-3W with a modified protocol of weekly paclitaxel 80 mg/m and weekly carboplatin AUC2 administered on days 1, 8, and 15 in a 28-day cycle (i.e., with 1 week off-treatment [PC-W]).
Medical records of consecutive patients treated between 2000 and 2018 were reviewed; 707 patients were analyzed for demographic and clinical characteristics, effectiveness and toxicity.
PC-3W was administered to 402 patients (median age, 60.5 years) and PC-W to 305 patients (median age, 62.5 years). Most patients (91.4%) were diagnosed at stage III-IV. Notwithstanding a higher proportion of residual disease and older patients in the PC-W group, median progression-free survival was 21.4 months and 13.2 months for PC-W and PC-3W, respectively; median overall survival was 75.2 and 54.0 months for PC-W and PC-3W, respectively. Cox proportional hazards model indicated improved survival for patients treated with PC-W (hazard ratio, 0.54). Similar results were observed for older patients diagnosed at ≥75 years. PC-W demonstrated a better safety profile, with lower incidence of neuropathy, neutropenia, and alopecia.
PC-W is as active and better tolerated than the standard PC-3W regimen. PC-W may serve as an alternative option for elderly or frail patients.
Weekly scheduling of paclitaxel 80 mg/m and carboplatin AUC2, administered on days 1, 8, and 15 in a 28-day cycle (PC-W) for first-line therapy for advanced ovarian cancer, is as active and better tolerated than the standard regimen of carboplatin and paclitaxel (175 mg/m ) every 3 weeks (PC-3W). It is possible that the weekly holiday on day 21 in the PC-W regimen may ensure better completion rates (which may result in treatment delays for toxicity in PC-3W). The results of this retrospective analysis highlight the weekly regimen as a valid treatment option, especially for elderly patients and those with significant comorbidities.
卵巢癌的常规一线联合治疗包括 6 个周期的辅助或新辅助卡铂（AUC5-6）与紫杉醇（175mg/m ），每 3 周 1 次（PC-3W）。紫杉醇每周给药可能最大限度地发挥其抗血管生成作用并减少不良反应。我们比较了 PC-3W 与每周紫杉醇 80mg/m 和每周卡铂 AUC2 的改良方案的疗效和安全性，后者在 28 天周期的第 1、8 和 15 天给药（即，1 周停药[PC-W]）。
回顾性分析了 2000 年至 2018 年连续治疗的患者的病历；对 707 例患者进行了人口统计学和临床特征、有效性和毒性分析。
PC-3W 用于 402 例患者（中位年龄 60.5 岁），PC-W 用于 305 例患者（中位年龄 62.5 岁）。大多数患者（91.4%）诊断为 III-IV 期。尽管 PC-W 组的残留疾病和老年患者比例较高，但 PC-W 和 PC-3W 的中位无进展生存期分别为 21.4 个月和 13.2 个月；中位总生存期分别为 PC-W 和 PC-3W 的 75.2 个月和 54.0 个月。Cox 比例风险模型表明，PC-W 治疗的患者生存改善（风险比，0.54）。≥75 岁的老年患者也观察到了类似的结果。PC-W 具有更好的安全性，神经病变、中性粒细胞减少和脱发的发生率较低。
PC-W 与标准的 PC-3W 方案一样有效且耐受性更好。PC-W 可能是老年或体弱患者的另一种选择。
每周紫杉醇 80mg/m 和卡铂 AUC2 ，在第 1、8 和 15 天给药，在 28 天周期（PC-W）中用于晚期卵巢癌的一线治疗，与标准方案（卡铂和紫杉醇 175mg/m ）一样有效且耐受性更好，每 3 周 1 次（PC-3W）。PC-W 方案中第 21 天每周休息 1 天可能确保更好的完成率（这可能导致 PC-3W 因毒性而延迟治疗）。这项回顾性分析的结果强调了每周方案作为一种有效的治疗选择，特别是对于老年患者和有显著合并症的患者。
