复发性和转移性上皮性卵巢癌姑息性口服节拍化疗三联疗法：一项回顾性研究。

Triple combination of palliative oral metronomic chemotherapy in recurrent and metastatic epithelial ovarian cancer: A retrospective study.

作者信息

Harsh Kamlesh K, Jakhar Shankar L, Maheshwari Guncha, Nirban Rajkumar, Kumari Pramila, Beniwal Surender K, Sharma Neeti, Kumar Harvindra S

机构信息

Department of Radiation Oncology, Sardar Patel Medical College, Bikaner, Rajasthan, India.

Palliative Medicine, Sardar Patel Medical College, Bikaner, Rajasthan, India.

出版信息

Indian J Cancer. 2023 Apr-Jun;60(2):167-172. doi: 10.4103/ijc.IJC_143_20.

DOI:10.4103/ijc.IJC_143_20

PMID:37530237

Abstract

BACKGROUND

Ovarian cancer is a leading cause of death from gynecological cancer in the world and in India. This study aims to evaluate the efficacy and toxicity profile of oral metronomic chemotherapy (MCT) in the form of etoposide, cyclophosphamide, and tamoxifen in recurrent and metastatic ovarian cancer.

METHODS

This was a retrospective observational study that included those post-treatment patients who had the recurrent or metastatic disease after completion of treatment in 2018 at Regional Cancer Centre, Bikaner, Rajasthan. Forty patients who were unfit for further intensive intravenous chemotherapy were included. The oral MCT constituted etoposide, cyclophosphamide, and tamoxifen. Descriptive statistics and Kaplan-Meier analyses were performed. Progression-free survival (PFS) and overall survival (OS) were assessed.

RESULTS

Forty women with a median age of 62 (range: 35-80) years were enrolled in the study to receive oral MCT. The Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) was 0-1 in 28 patients and 2-3 in 12 patients. The best clinical response rate post-oral MCT was seen in the first 4 months. Objective response was observed in 24 (60%) of patients in the form of stable disease (19, 47.5%) and partial response (5, 12.5%). Disease progression was observed in 10 (25%) of patients. The median follow-up was 6.4 months (4.5-9.2 months). The median estimated OS was 6.5 months. The median estimated PFS was 3.7 months. Nineteen (47.5%) patients had grade-I/II mucositis. Grade-III/IV mucositis were observed in 9 (22.5%) patients. Thirty-seven (92.5%) patients died at the end of the study at 1 year. Dose reduction was required in 15 (37.5%) patients.

CONCLUSION

Oral MCT was found to be an effective and well-tolerated regime with good symptomatic control and low-moderate toxicity profile in patients with relapsed and metastatic ovarian cancer. However, 22% of patients showed grade-III/IV thrombocytopenia.

摘要

背景

卵巢癌是全球及印度妇科癌症死亡的主要原因。本研究旨在评估依托泊苷、环磷酰胺和他莫昔芬形式的口服节拍化疗（MCT）在复发性和转移性卵巢癌中的疗效和毒性特征。

方法

这是一项回顾性观察研究，纳入了2018年在拉贾斯坦邦比卡内尔地区癌症中心完成治疗后出现复发或转移性疾病的治疗后患者。纳入了40例不适合进一步强化静脉化疗的患者。口服MCT由依托泊苷、环磷酰胺和他莫昔芬组成。进行了描述性统计和Kaplan-Meier分析。评估了无进展生存期（PFS）和总生存期（OS）。

结果

40名年龄中位数为62岁（范围：35 - 80岁）的女性纳入本研究接受口服MCT。东部肿瘤协作组体能状态（ECOG-PS）为0 - 1级的患者有28例，2 - 3级的患者有12例。口服MCT后的最佳临床缓解率出现在前4个月。24例（60%）患者出现客观缓解，表现为疾病稳定（19例，47.5%）和部分缓解（5例，12.5%）。10例（25%）患者出现疾病进展。中位随访时间为6.4个月（4.5 - 9.2个月）。中位估计总生存期为6.5个月。中位估计无进展生存期为3.7个月。19例（47.5%）患者出现I/II级粘膜炎。9例（22.5%）患者出现III/IV级粘膜炎。37例（92.5%）患者在研究1年结束时死亡。15例（37.5%）患者需要降低剂量。