Kim Junhwan, Park Eun-Byul, Lee Shin-Wha, Park Jeong-Yeol, Kim Dae-Yeon, Suh Dae-Shik, Kim Jong-Hyeok, Kim Yong-Man, Kim Ju-Hyun
Center for Gynecologic Cancer, National Cancer Center, Goyang 10408, Republic of Korea.
Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
Taiwan J Obstet Gynecol. 2025 Jan;64(1):61-67. doi: 10.1016/j.tjog.2020.07.035.
To investigate the real-world efficacy and toxicity of paclitaxel-cisplatin-bevacizumab and identify prognostic factors for paclitaxel-cisplatin-bevacizumab in platinum-naïve primary stage IVB cervical cancer.
We retrospectively reviewed patients with stage IVB cervical cancer who received paclitaxel-cisplatin-bevacizumab as first-line treatment between July 2015 and December 2021 at Asan Medical Center, Korea. Patient data including clinicopathologic characteristics, imaging, paclitaxel-cisplatin-bevacizumab administration, recurrence, and survival were collected.
Overall, 61 patients were included in this study. The median age of the patients was 56 (range, 28-79) years. Patients received a median of 9 (range, 2-30) cycles of paclitaxel-cisplatin-bevacizumab. The most common adverse event (all grades) during treatment was azotemia (80.3 %). Dose reduction and drug interruption were conducted in 41.0 % and 26.2 % of patients, respectively. The median progression-free survival (PFS) and the median overall survival (OS) were 11.8 (95 % confidence interval [CI], 9.3-14.2) and 24.3 (95 % CI, 16.9-31.7) months, respectively. Multivariate analysis indicated that cervical mass size reduction rate ≥40 % at the longest diameter was an independent prognostic factor for PFS (adjusted hazard ratio, 0.24; 95 % CI, 0.11-0.53; p < 0.001). The median PFS of the patients with cervical mass size reduction rate ≥40 % and <40 % were 13.7 (95 % CI, 10.9-16.5) and 5.9 (95 % CI, 0-12.6) months, respectively (p < 0.001).
Paclitaxel-cisplatin-bevacizumab is effective and tolerable as a first-line treatment for platinum-naïve primary stage IVB cervical cancer. Cervical mass size reduction rate ≥40 % during paclitaxel-cisplatin-bevacizumab treatment might be a potential prognostic factor for PFS in patients with platinum-naïve primary stage IVB cervical cancer.
探讨紫杉醇-顺铂-贝伐单抗在真实世界中的疗效和毒性，并确定初治的原发性IVB期宫颈癌患者接受紫杉醇-顺铂-贝伐单抗治疗的预后因素。
我们回顾性分析了2015年7月至2021年12月在韩国峨山医学中心接受紫杉醇-顺铂-贝伐单抗一线治疗的IVB期宫颈癌患者。收集患者的临床病理特征、影像学检查、紫杉醇-顺铂-贝伐单抗给药情况、复发及生存等数据。
本研究共纳入61例患者。患者的中位年龄为56岁（范围28 - 79岁）。患者接受紫杉醇-顺铂-贝伐单抗治疗的中位周期数为9个周期（范围2 - 30个周期）。治疗期间最常见的不良事件（所有级别）为氮质血症（80.3%）。分别有41.0%和26.2%的患者进行了剂量减少和药物中断。中位无进展生存期（PFS）和中位总生存期（OS）分别为11.8个月（95%置信区间[CI]，9.3 - 14.2）和24.3个月（95%CI，16.9 - 31.7）。多因素分析表明，最长直径处宫颈肿块大小缩小率≥40%是PFS的独立预后因素（调整后风险比，0.24；95%CI，0.11 - 0.53；p < 0.001）。宫颈肿块大小缩小率≥40%和<40%的患者中位PFS分别为13.7个月（95%CI，10.9 - 16.5）和5.9个月（95%CI，0 - 12.6）（p < 0.001）。
紫杉醇-顺铂-贝伐单抗作为初治的原发性IVB期宫颈癌的一线治疗是有效且可耐受的。紫杉醇-顺铂-贝伐单抗治疗期间宫颈肿块大小缩小率≥40%可能是初治的原发性IVB期宫颈癌患者PFS的一个潜在预后因素。
