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.
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.
