Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States.
Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States.
Gynecol Oncol. 2020 Sep;158(3):653-658. doi: 10.1016/j.ygyno.2020.06.498. Epub 2020 Jul 22.
Low-grade serous carcinoma of the ovary/peritoneum (LGSC) is relatively chemoresistant in the adjuvant, neoadjuvant, and recurrent settings. We sought to expand our prior work and evaluate response rates of women with LGSC to neoadjuvant chemotherapy (NACT) compared to women with high-grade serous carcinoma of the ovary/peritoneum (HGSC).
Thirty-six patients with LGSC who received NACT were matched to patients with HGSC. A single radiologist re-reviewed pre- and post-NACT imaging for response using RECIST 1.1. Pre- and post-NACT CA-125 values were compared using paired t-tests. Kaplan-Meier estimates of progression free survival (PFS) and overall survival (OS) were performed.
All patients received neoadjuvant platinum-based regimens. LGSC patients received a median of 5 cycles (range 3-9), HGSC patients received a median of 4 cycles (range 3-9). Interval cytoreductive surgery was performed in 29/36 (81%) of LGSC and 32/36 (89%) HGSC patients. Complete cytoreduction was reported and achieved in 11/29 (38%) of LGSC patients and 24/32 (75%) of HGSC patients (p = 0.002). Median pre- and post-treatment CA-125 levels for LGSC patients were 295.5 U/mL and 144 U/mL (52% decrease) (p < 0.001). The median pre- and post-treatment CA-125 levels for HGSC patients were 767.5 and 35.6 (96% decrease) (p < 0.001). For LGSC patients, 4/36 (11%) had partial response (PR), 30/36 (83%) had stable disease (SD), and 2/36 (6%) had progressive disease (PD). In HGSC patients, 27/36 (75%) had PR, and 9/36 (25%) SD. Median PFS for LGSC patients was 18.5 months and median OS was 47.4 months.
This study provides further evidence of relative chemoresistance of LGSC in patients treated with NACT.
卵巢/腹膜低级别浆液性癌（LGSC）在辅助治疗、新辅助治疗和复发治疗中相对化疗耐药。我们试图扩大先前的研究范围，并评估接受新辅助化疗（NACT）的 LGSC 女性与卵巢/腹膜高级别浆液性癌（HGSC）女性的反应率。
对 36 例接受 NACT 的 LGSC 患者进行匹配，以匹配 HGSC 患者。一位单独的放射科医生使用 RECIST 1.1 重新评估 NACT 前后的影像学反应。使用配对 t 检验比较 NACT 前后的 CA-125 值。进行无进展生存（PFS）和总生存（OS）的 Kaplan-Meier 估计。
所有患者均接受新辅助铂类为基础的方案治疗。LGSC 患者接受中位数为 5 个周期（范围 3-9），HGSC 患者接受中位数为 4 个周期（范围 3-9）。29/36（81%）LGSC 和 32/36（89%）HGSC 患者接受了间隔性细胞减灭术。29/29（38%）LGSC 和 24/32（75%）HGSC 患者报告并实现了完全细胞减灭（p=0.002）。LGSC 患者治疗前后 CA-125 水平中位数分别为 295.5 U/mL 和 144 U/mL（下降 52%）（p<0.001）。HGSC 患者治疗前后 CA-125 水平中位数分别为 767.5 和 35.6 U/mL（下降 96%）（p<0.001）。LGSC 患者中，4/36（11%）有部分缓解（PR），30/36（83%）有稳定疾病（SD），2/36（6%）有进展性疾病（PD）。HGSC 患者中，27/36（75%）有 PR，9/36（25%）SD。LGSC 患者的中位 PFS 为 18.5 个月，中位 OS 为 47.4 个月。
这项研究为 NACT 治疗的 LGSC 患者相对化疗耐药提供了进一步的证据。
