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上皮性卵巢癌患者铂类化疗耐药的相关临床因素

Related Clinical Factors of Platinum-Based Chemotherapy Resistance in Patients with Epithelial Ovarian Cancer.

作者信息

Xiong Zhuo, Ha Chunfang, Li Ruyue, Wu Mingyong, Wei Meng

机构信息

Department of Gynecologic Oncology, General Hospital of Ningxia Medical University, Yinchuan, China,

Department of Gynecology, General Hospital of Ningxia Medical University, Yinchuan, China.

出版信息

Gynecol Obstet Invest. 2024;89(6):469-477. doi: 10.1159/000539295. Epub 2024 Jun 5.

Abstract

OBJECTIVE

Ovarian cancer is the second most common malignancy in women, but it is a fatal gynecological tumor. Although it has a standard treatment regimen, resistance to chemotherapy makes patients more prone to early recurrence, leading to poor survival rates. Therefore, this study investigated factors related to platinum resistance through a complete analysis of clinical data.

DESIGN

Clinical data of patients with ovarian cancer were collected, and the patients were categorized into platinum-sensitive and platinum-resistant groups. By comparing the differences in clinical data between the groups, the key factors affecting platinum resistance were analyzed.

PARTICIPANTS/MATERIALS, SETTING, METHODS: We collected the clinical data of patients with epithelial ovarian cancer (EOC) who were admitted to the Department of Oncology of the General Hospital of Ningxia Medical University between January 1, 2019, and December 31, 2020. We conducted univariate and multivariate analyses and evaluated overall survival and progression-free survival using the Kaplan-Meier method.

RESULTS

We enrolled 161 patients with EOC, of whom 124 demonstrated platinum sensitivity and 37 demonstrated platinum resistance after the initial platinum-based chemotherapy. Univariate analyses revealed that the International Federation of Gynecology and Obstetrics (FIGO) stage, neoadjuvant chemotherapy, and Fagotti score were associated with an increased risk of platinum resistance for the first recurrence. In multivariate logistic regression analysis, only Fagotti score and neoadjuvant chemotherapy were associated with an increased risk of platinum resistance (odds ratio: 0.372 and 0.328, 95% confidence interval: 0.160-0.863 and 0.141-0.762, p = 0.021 and 0.010, respectively).

LIMITATIONS

The sample size of this study was relatively small because of nonstandard treatment of some patients, the absence of clinical data, and failure of follow-up.

CONCLUSIONS

Patients with EOC exhibiting platinum resistance had a very poor prognosis. The Fagotti score and neoadjuvant chemotherapy appeared to increase the risk of platinum resistance at first recurrence.

摘要

目的

卵巢癌是女性第二常见的恶性肿瘤,却是一种致命的妇科肿瘤。尽管有标准治疗方案,但化疗耐药使患者更易早期复发,导致生存率低下。因此,本研究通过全面分析临床数据来探究铂耐药相关因素。

设计

收集卵巢癌患者的临床数据,并将患者分为铂敏感组和铂耐药组。通过比较两组临床数据的差异,分析影响铂耐药的关键因素。

参与者/材料、设置、方法:我们收集了2019年1月1日至2020年12月31日期间在宁夏医科大学总医院肿瘤科住院的上皮性卵巢癌(EOC)患者的临床数据。进行单因素和多因素分析,并采用Kaplan-Meier法评估总生存期和无进展生存期。

结果

我们纳入了161例EOC患者,其中124例在初始铂类化疗后表现为铂敏感,37例表现为铂耐药。单因素分析显示,国际妇产科联盟(FIGO)分期、新辅助化疗和Fagotti评分与首次复发时铂耐药风险增加有关。在多因素逻辑回归分析中,只有Fagotti评分和新辅助化疗与铂耐药风险增加有关(比值比:0.372和0.328,95%置信区间:0.160 - 0.863和0.141 - 0.762,p分别为0.021和0.010)。

局限性

由于部分患者治疗不规范、缺乏临床数据以及随访失败,本研究样本量相对较小。

结论

表现出铂耐药的EOC患者预后非常差。Fagotti评分和新辅助化疗似乎会增加首次复发时铂耐药的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a44f/11633879/38b2b7515d04/goi-2024-0089-0006-539295_F01.jpg

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