Brink Geertruid J, Groeneweg Jolijn W, Hooft Lotty, Zweemer Ronald P, Witteveen Petronella O
Department of Gynaecological Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands.
Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands.
Cancers (Basel). 2022 Jun 17;14(12):2998. doi: 10.3390/cancers14122998.
For adult granulosa cell tumors (aGCTs), the preferred treatment modality is surgery. Chemotherapy and anti-hormonal therapy are also frequently used in patients with recurrent aGCT. We aimed to review the existing literature on the response to chemotherapy and anti-hormonal therapy in patients with aGCT. Embase and MEDLINE were searched from inception to November 2021 for eligible studies. Objective response rate (ORR) was calculated as the total number of cases with a complete response (CR) or a partial response (PR). Disease control rate (DCR) was defined as the sum of cases with CR, PR or stable disease (SD). A total of 10 studies were included that reported on chemotherapy and 13 studies were included that reported on anti-hormonal therapy. The response rates of the 56 chemotherapy regimens that could be evaluated resulted in an ORR of 30% and DCR of 58%. For anti-hormonal therapy, the results of 73 regimens led to an ORR of 11% and a DCR of 66%. Evidence on systemic therapy in aGCT only is limited. For both chemotherapy and anti-hormonal therapy, the ORR is limited, but the response is considerably higher when patients achieving SD are included. New approaches are needed to provide more evidence and standardize treatment in aGCT.
对于成人颗粒细胞瘤（aGCT），首选的治疗方式是手术。化疗和抗激素治疗也常用于复发性aGCT患者。我们旨在回顾现有关于aGCT患者对化疗和抗激素治疗反应的文献。检索了Embase和MEDLINE数据库，从建库至2021年11月，以查找符合条件的研究。客观缓解率（ORR）计算为完全缓解（CR）或部分缓解（PR）的病例总数。疾病控制率（DCR）定义为CR、PR或疾病稳定（SD）的病例数总和。共纳入10项报告化疗情况的研究和13项报告抗激素治疗情况的研究。可评估的56种化疗方案的缓解率导致ORR为30%，DCR为58%。对于抗激素治疗，73种方案的结果导致ORR为11%，DCR为66%。仅关于aGCT全身治疗的证据有限。对于化疗和抗激素治疗，ORR都有限，但当纳入达到SD的患者时，缓解率会显著更高。需要新的方法来提供更多证据并规范aGCT的治疗。
