Sweeten K M, Gershenson D M, Burke T W, Morris M, Levenback C, Silva E G
Department of Gynecologic Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Gynecol Oncol. 1995 Nov;59(2):211-5. doi: 10.1006/gyno.1995.0010.
Transitional cell carcinoma (TCC) of the ovary is reportedly more sensitive to first-line chemotherapy and has a better prognosis than the more common serous carcinoma. The purpose of this study was to determine the responsiveness of refractory ovarian TCC to salvage chemotherapy.
Thirty-three patients with refractory TCC who received either platinum drugs or taxanes as salvage chemotherapy at our institution were identified through a retrospective review. Clinical information was abstracted from the medical records, and patient characteristics and response rates were determined. Pathologic sections from all cases were reviewed.
The median age of the 33 patients was 53 years (range, 39-71 years). FIGO stage distribution among patients included 1 stage II and 32 stage III. Twenty-six tumors (79%) were classified as TCC-predominant (> 50% of the tumor having the TCC pattern), and seven tumors (21%) were classified as non-TCC predominant (< 50% of the tumor having the TCC pattern). Twenty-four platinum-sensitive patients received salvage platinum therapy (cisplatin, carboplatin, or other platinum analogs) on 27 separate occasions (three patients were treated twice) either as single agents (n = 20) or in combination (n = 7). In 21 of the 27 instances, patients had measurable disease and were evaluable for response. There were nine (43%) complete responses and six (29%) partial responses; in six instances, no response was observed. The overall response rate was therefore 72%. Thirteen patients, of whom 12 had measurable disease, received taxanes (paclitaxel in 10, docetaxel in 2, and paclitaxel+cisplatin in 1). There were partial responses in six (50%) and no response in six. Only one of the responders received high-dose paclitaxel (250 mg/m2).
Our findings suggest that TCC may remain more chemosensitive than more common epithelial tumors in the refractory setting. The relative influences of tumor biology and treatment, however, remain undetermined.
据报道，卵巢移行细胞癌（TCC）对一线化疗更敏感，且预后比更常见的浆液性癌更好。本研究的目的是确定难治性卵巢TCC对挽救性化疗的反应性。
通过回顾性研究，确定了33例在我院接受铂类药物或紫杉烷类药物作为挽救性化疗的难治性TCC患者。从病历中提取临床信息，并确定患者特征和缓解率。对所有病例的病理切片进行复查。
33例患者的中位年龄为53岁（范围39 - 71岁）。患者的国际妇产科联盟（FIGO）分期分布为1例II期和32例III期。26个肿瘤（79%）被分类为TCC为主型（肿瘤中>50%具有TCC模式），7个肿瘤（21%）被分类为非TCC为主型（肿瘤中<50%具有TCC模式）。24例铂敏感患者接受了挽救性铂类治疗（顺铂、卡铂或其他铂类类似物），共27次（3例患者接受了两次治疗），其中单药治疗（n = 20）或联合治疗（n = 7）。在这27例中的21例中，患者有可测量的疾病且可评估反应。有9例（43%）完全缓解，6例（29%）部分缓解；6例未观察到反应。因此，总缓解率为72%。13例患者，其中12例有可测量的疾病，接受了紫杉烷类治疗（10例接受紫杉醇，2例接受多西他赛，1例接受紫杉醇+顺铂）。6例（50%）有部分缓解，6例无反应。只有1例缓解者接受了高剂量紫杉醇（250 mg/m²）。
我们的研究结果表明，在难治性情况下，TCC可能比更常见的上皮性肿瘤对化疗更敏感。然而，肿瘤生物学和治疗的相对影响仍未确定。
