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Carboplatin plus paclitaxel weekly dose-dense chemotherapy for high-grade ovarian cancer: A re-evaluation.

卡铂加紫杉醇每周剂量密集化疗治疗高级别卵巢癌: 再评价。

  • 影响因子:2.21
  • DOI:10.1111/aogs.14023
  • 作者列表:"Kessous R","Matanes E","Laskov I","Wainstock T","Abitbol J","Yasmeen A","Salvador S","Lau S","Gotlieb WH
  • 发表时间:2021-03-01
Abstract

INTRODUCTION:We compared oncologic and clinical outcomes in patients with advanced ovarian cancer who received dose-dense weekly paclitaxel with 3-weekly carboplatin with those who received standard 3-weekly chemotherapy. MATERIAL AND METHODS:Comparison of all consecutive patients with advanced (International Federation of Gynecology and Obstetrics stages III-IV) ovarian cancer who received a dose-dense protocol between 2010 and 2016 with an immediate historical cohort of consecutive patients who received standard chemotherapy. Patients who received less than three cycles of treatment were excluded. RESULTS:In all, 246 patients were included in the study, of whom 128 received the dose-dense protocol and 118 were treated with the standard Q3-week protocol. Patients in the dose-dense group had significantly better progression-free survival than those receiving the standard protocol (median progression-free survival 22 vs 15 months; log rank = 0.026). The overall survival of patients in the dose-dense group was also better than that of the patients in the standard protocol group; however, this difference was not statistically significant (median overall survival 66 vs 54 months; log rank = 0.185). The dose-dense protocol remained significantly associated with favorable survival outcome in multivariable analysis adjusted for stage, histologic type, cytoreductive results and neoadjuvant chemotherapy. The use of the dose-dense protocol was associated with higher rates of gastrointestinal, dermatologic, neurologic and hematologic side effects. CONCLUSION:Despite the limitations associated with the comparison to a historical cohort, a dose-dense chemotherapy protocol resulted in a significantly improved progression-free survival and the overall survival tended to be better, but this difference did not reach statistical significance compared with the standard chemotherapy protocol, and may be considered as a treatment alternative, albeit with some increased side effects.

摘要

引言: 我们比较了接受每周剂量密集紫杉醇和每周3次卡铂的晚期卵巢癌患者与接受标准每周3次化疗的患者的肿瘤学和临床结局。 材料和方法: 比较2010年至2016年间接受剂量密集方案的所有晚期 (国际妇产科联盟iii-iv期) 卵巢癌患者与接受标准化疗的连续患者的直接历史队列。接受少于三个周期治疗的患者被排除在外。 结果: 共有246例患者纳入研究,其中128例接受剂量密集方案,118例接受标准Q3-week方案治疗。剂量密集组患者的无进展生存期显著优于接受标准方案的患者 (中位无进展生存期22个月vs 15个月; log rank = 0.026).剂量密集组患者的总生存期也优于标准方案组患者; 然而,这种差异没有统计学意义 (中位总生存期66个月vs 54个月; log rank = 0.185)。在对分期、组织学类型、细胞减灭结果和新辅助化疗进行校正的多变量分析中,剂量密集方案仍然与良好的生存结局显著相关.剂量密集方案的使用与较高的胃肠道、皮肤病、神经和血液学副作用发生率相关。 结论: 尽管与历史队列相比存在局限性,但剂量密集的化疗方案导致无进展生存期显著改善,总生存期趋于更好,但与标准化疗方案相比,这种差异没有达到统计学意义,并可能被认为是一种治疗替代方案,虽然有一些增加的副作用。

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DOI:10.1007/s11033-021-06299-9
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