以铂类为主的化疗方案对老年晚期卵巢癌患者的疗效

作     者：Hershman D. Jacobson J.S. McBride R. 张剑萍 

作者机构：Dept. Med. Herbert Irving C. College of Physicians and Surgeons Columbia University 10032 NewYork NYUnited States 

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：61-62页

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

主　　题：晚期卵巢癌 联合化疗 倾向评分 存活期 试验研究结果 模型评估 医疗数据库 随机对照试验 率更 日至 

摘      要：Background. Platinum-based chemotherapy is the standard of care for wo men wit h advanced ovarian cancer based on the results of randomized trials. We previous ly showed that only about half of women over the age of 65 years with this disea se received platinum-based chemotherapy, and that the likelihood of receiving i t decreases with age. Methods. We used the Surveillance, Epidemiology, and End R esults (SEER)-Medicare database to identify women diagnosed from 1/1/92 to 12/3 1/96 with stage III or IV ovarian cancer who survived ≥120 days beyond diagnosi s, and were ≥65 years of age. Cox proportional hazards models and propensity sc ores were used to control for known predictors of receiving treatment and to est imate the relative effectiveness of different platinum-based regimens. Results. Of the 1759 patients in the sample who met our eligibility criteria, 53%receiv ed platinum-based therapy. For this sample, the Cox proportional hazard ratio w as 0.72 (95%CI, 0.62-0.91) for mortality associated with the use of any platin um-based therapy, and 0.59 (95%CI, 0.45-0.76) for combination platinum/paclit axel therapy. Similar results were obtained using propensity score modeling. Con clusions. In this population-based study, we found that only about half of wome n with advanced ovarian cancer over age 65 were treated with platinum-based che motherapy; however, survival improved by 38%in treated women, similar to the be nefits described in randomized controlled trials among younger patients, and wer e greatest when platinum was combined with paclitaxel. An effort to increase the utilization of platinum combination therapy among older patients with advanced ovarian cancer is justified.