新诊断的 II-IV 期上皮性卵巢、输卵管或原发性腹膜癌的新辅助和辅助全身治疗：系统评价。

Neoadjuvant and adjuvant systemic therapy for newly diagnosed stage II- IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma: A systematic review.

机构信息

Division of Medical Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada.

Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), Department of Oncology, McMaster University, Hamilton, Ontario, Canada.

出版信息

Crit Rev Oncol Hematol. 2021 Jun;162:103324. doi: 10.1016/j.critrevonc.2021.103324. Epub 2021 Apr 20.

DOI:10.1016/j.critrevonc.2021.103324

PMID:33862245

Abstract

BACKGROUND

To systematically review neoadjuvant and adjuvant therapy options for women with newly diagnosed stage II-IV ovarian cancer.

METHODS

Phase III trials were searched using MEDLINE, EMBASE, and Cochrane Library. Maintenance therapies were excluded.

RESULTS

Thirty-three trials were included. For women with high-risk profiles that would contraindicate upfront cytoreductive surgery, neoadjuvant chemotherapy can be an option. In the post-surgical adjuvant setting, the three-weekly regimen consisting of paclitaxel and carboplatin remains the standard of care. Docetaxel may be offered to those who are unable to tolerate paclitaxel. Intraperitoneal cisplatin and paclitaxel increased OS for stage III optimally debulked women (GOG 172). The intraperitoneal regimens in GOG 252 offered no survival benefit and some harms in terms of toxicity and quality of life.

CONCLUSIONS

There is no evidence to support adding a third agent to the standard carboplatin and paclitaxel. Results of the iPocc study will clarify the role of intraperitoneal chemotherapy.

摘要

背景

系统地回顾新诊断为 II-IV 期卵巢癌的女性的新辅助和辅助治疗选择。

方法

使用 MEDLINE、EMBASE 和 Cochrane 图书馆搜索 III 期试验。排除维持治疗。

结果

共纳入 33 项试验。对于不适合 upfront 细胞减灭术的高危患者，新辅助化疗是一种选择。在手术后辅助治疗环境中，由紫杉醇和卡铂组成的三周方案仍然是标准治疗。对于不能耐受紫杉醇的患者，可以给予多西紫杉醇。腹腔内顺铂和紫杉醇增加了 III 期最佳减瘤的女性的 OS（GOG 172）。GOG 252 中的腹腔内方案在毒性和生活质量方面没有生存获益，反而存在一些危害。