Gynecol Oncol. 1986 Jan;23(1):1-13. doi: 10.1016/0090-8258(86)90109-5.
Three hundred and sixty-nine patients with advanced ovarian adenocarcinoma were treated in a prospective randomized trial comparing combination versus sequential therapy with chlorambucil and cisplatin. Initial tumor response rates were similar but combination chemotherapy was associated with significantly prolonged time to first disease progression (median 28 weeks for chlorambucil and 42 weeks for combination chemotherapy). Second-line treatment with cisplatin in patients failing initial chlorambucil caused tumor response in 16.9%. Overall time to ultimate disease progression was similar between the treatment groups. The surgically documented complete response rate (second-look surgery at approximately equal to 12 months) and the survival was similar in the two treatment arms. Multivariate analysis of prognostic factors for survival in this trial showed that bulk of residual disease at time of starting therapy and the development of myelosuppression during therapy were the most important.
369例晚期卵巢腺癌患者参与了一项前瞻性随机试验，比较苯丁酸氮芥与顺铂联合治疗和序贯治疗的效果。初始肿瘤缓解率相似，但联合化疗与显著延长至首次疾病进展的时间相关（苯丁酸氮芥治疗的中位时间为28周，联合化疗为42周）。初始接受苯丁酸氮芥治疗失败的患者接受顺铂二线治疗，肿瘤缓解率为16.9%。治疗组间至最终疾病进展的总时间相似。两个治疗组的手术记录完全缓解率（约12个月时进行二次探查手术）和生存率相似。该试验对生存预后因素的多变量分析显示，开始治疗时残留疾病的数量和治疗期间骨髓抑制的发生是最重要的因素。
