使用紫杉醇-铂类预处理的卵巢癌患者二线治疗中疾病稳定状况是否为存活的有效指标

作     者：Gronlund B. Hdall C. Christensen I.J. 王刚 

作者机构：Department of Onco logy The Finsen CenterRigshospitalet Copenhagen Univ. H. Copenhagen Denmark 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2005年第1卷第1期

页      面：50-50页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：二线治疗 复发性卵巢癌 肿瘤预后 生存分析 生存优势 一线化疗 独立预后因素 影像学诊断 多变量回归 持续性 

摘      要：Objective. Recurrent ovarian carcinoma is considered an incurable dis ease and second-line chemotherapy is administered for extension of survival and palliati on. The impact of continued antineoplastic treatment in patients with stable dis ease without a demonstrable response is uncertain. The aim of this analysis was to assess the value of a stabilization of the tumor size in second-line chemoth erapy as an indicator of survival. Methods. Retrospective, single-institution s tudy of 487 consecutive patients with primary epithelial ovarian carcinoma. Incl usion criteria: (1) FIGO stage IC-IV epithelial ovarian carcinoma; (2) first-l ine chemotherapy with Paclitaxel and a Platinum-compound; (3) refractory, persi stent, or recurrent disease diagnosed by imaging methods; and (4) intravenous se cond-line chemotherapy with single Topotecan or Paclitaxel-Carboplatin. Univar iate and multivariate analyses of survival with theWorld Health Organization (WH O) tumor response parameter included as a time-dependent variable were performe d. Results. The response rates were (N = 100): complete response (CR) 27%, part ial response (PR) 14%, stable disease (SD) 41%and progressive disease (PD) 18 %. In a multivariate Cox regression analysis of survival, SD was found to be an independent prognostic factor for survival and the death hazard ratio was 0.37 (SD versus PD; 95%CI: 0.16-0.86; P = 0.02). There was no statistically signifi cant difference in survival between patients with PR and SD (P = 0.09). Conclusi on. In secondline chemotherapy of ovarian cancer,patients demonstrating SD have a survival benefit compared to patients with PD measured by theWHO tumor respons e criteria.