Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.
Department of Gynecologic Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya-shi, Aichi, 464-8681, Japan.
Int J Clin Oncol. 2022 Mar;27(3):609-618. doi: 10.1007/s10147-021-02075-8. Epub 2021 Nov 15.
Previous studies on adjuvant chemotherapy for patients with ovarian clear cell carcinoma (OCCC) have included a limited number of Asian patients with surgical stage I OCCC, despite differences in OCCC survival by race and stage. The aim of this study was to estimate the survival effect of the number of cycles of adjuvant taxane plus carboplatin chemotherapy in Asian patients with surgical stage I OCCC.
We retrospectively identified 227 patients with surgical stage I OCCC at 14 institutions from 1995 to 2017. Kaplan-Meier analysis and Cox proportional hazard regression with inverse probability of treatment weighting (IPTW) adjustment were performed to evaluate overall survival (OS) and recurrence-free survival (RFS) in patients receiving ≤ 3 and 4-6 cycles of taxane plus platinum adjuvant chemotherapy.
Eighty-nine and 138 patients received ≤ 3 and 4-6 cycles of adjuvant chemotherapy, respectively. There was no between-group difference in OS or RFS with or without IPTW adjustment. In Cox proportional hazards analysis, 4-6 cycles of adjuvant chemotherapy were not associated with improved OS (HR 1.090; 95% CI 0.518-2.291; p = 0.821) or RFS (HR 1.144; 95% CI 0.619-2.114; p = 0.669) compared to ≤ 3 cycles, even with IPTW adjustment. Subgroup analysis in different substages of stage I OCCC showed that the number of cycles of adjuvant chemotherapy had no impact on OS or RFS.
Three or fewer cycles of taxane plus carboplatin chemotherapy may be a reasonable treatment regime for patients with surgical staging I OCCC.
此前关于卵巢透明细胞癌（OCCC）患者辅助化疗的研究纳入了数量有限的手术分期 I 期 OCCC 的亚洲患者，尽管种族和分期的不同会影响 OCCC 的生存率。本研究旨在评估手术分期 I 期 OCCC 亚洲患者接受紫杉烷加卡铂辅助化疗周期数的生存效果。
我们回顾性地在 1995 年至 2017 年间从 14 家机构中确定了 227 例手术分期 I 期 OCCC 患者。通过 Kaplan-Meier 分析和 Cox 比例风险回归（采用逆概率治疗加权（IPTW）调整）评估接受≤3 个周期和 4-6 个周期紫杉烷加铂类辅助化疗患者的总生存期（OS）和无复发生存期（RFS）。
分别有 89 例和 138 例患者接受了≤3 个周期和 4-6 个周期的辅助化疗。在有无 IPTW 调整的情况下，两组患者的 OS 或 RFS 均无差异。Cox 比例风险分析显示，与接受≤3 个周期化疗相比，接受 4-6 个周期辅助化疗并不能改善 OS（HR 1.090；95%CI 0.518-2.291；p=0.821）或 RFS（HR 1.144；95%CI 0.619-2.114；p=0.669），即使进行了 IPTW 调整也是如此。在不同 I 期 OCCC 亚分期的亚组分析中，辅助化疗周期数对 OS 或 RFS 没有影响。
紫杉烷加卡铂化疗 3 个周期或更少可能是手术分期 I 期 OCCC 患者的合理治疗方案。
