新辅助化疗后间隔减瘤手术治疗晚期上皮性卵巢癌：GOTIC-019 研究。
Neoadjuvant chemotherapy followed by interval debulking surgery for advanced epithelial ovarian cancer: GOTIC-019 study.
机构信息
Department of Obstetrics and Gynecology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan.
出版信息
Int J Clin Oncol. 2023 Jun;28(6):804-815. doi: 10.1007/s10147-023-02329-7. Epub 2023 May 4.
INTRODUCTION
Three randomized controlled trials have resulted in extremely extensive application of the strategy of using neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) for patients with advanced epithelial ovarian cancer in Japan. This study aimed to evaluate the status and effectiveness of treatment strategies using NAC followed by IDS in Japanese clinical practice.
PATIENTS AND METHODS
We conducted a multi-institutional observational study of 940 women with Federation of Gynecology and Obstetrics (FIGO) stages III-IV epithelial ovarian cancer treated at one of nine centers between 2010 and 2015. Progression-free survival (PFS) and overall survival (OS) were compared between 486 propensity-score matched participants who underwent NAC followed by IDS and primary debulking surgery (PDS) followed by adjuvant chemotherapy.
RESULTS
Patients with FIGO stage IIIC receiving NAC had a shorter OS (median OS: 48.1 vs. 68.2 months, hazard ratio [HR]: 1.34; 95% confidence interval [CI] 0.99-1.82, p = 0.06) but not PFS (median PFS: 19.7 vs. 19.4 months, HR: 1.02; 95% CI: 0.80-1.31, p = 0.88). However, patients with FIGO stage IV receiving NAC and PDS had comparable PFS (median PFS: 16.6 vs. 14.7 months, HR: 1.07 95% CI: 0.74-1.53, p = 0.73) and OS (median PFS: 45.2 vs. 35.7 months, HR: 0.98; 95% CI: 0.65-1.47, p = 0.93).
CONCLUSIONS
NAC followed by IDS did not improve survival. In patients with FIGO stage IIIC, NAC may be associated with a shorter OS.
简介
三项随机对照试验的结果导致日本广泛应用新辅助化疗（NAC）加间隔减瘤手术（IDS）的策略治疗晚期上皮性卵巢癌患者。本研究旨在评估 NAC 加 IDS 在日本临床实践中的治疗策略的现状和效果。
患者和方法
我们对 2010 年至 2015 年期间在 9 个中心中的一个接受联邦妇科和产科协会（FIGO）分期 III-IV 期上皮性卵巢癌治疗的 940 名女性进行了多机构观察性研究。比较了 486 名接受 NAC 加 IDS 和原发性减瘤手术（PDS）加辅助化疗的倾向评分匹配参与者的无进展生存期（PFS）和总生存期（OS）。
结果
接受 NAC 的 FIGO 分期 IIIC 患者的 OS 更短（中位 OS：48.1 与 68.2 个月，风险比[HR]：1.34；95%置信区间[CI]：0.99-1.82，p=0.06），但 PFS 无差异（中位 PFS：19.7 与 19.4 个月，HR：1.02；95%CI：0.80-1.31，p=0.88）。然而，接受 NAC 和 PDS 的 FIGO 分期 IV 患者的 PFS 相当（中位 PFS：16.6 与 14.7 个月，HR：1.07；95%CI：0.74-1.53，p=0.73）和 OS（中位 PFS：45.2 与 35.7 个月，HR：0.98；95%CI：0.65-1.47，p=0.93）。
结论
NAC 加 IDS 并未改善生存。在 FIGO 分期 IIIC 患者中，NAC 可能与较短的 OS 相关。
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