Objective. We compared the efficacy and side effects of taxanes, with or without platinum, to bleomycin, etoposide, and cisplatin (BEP) in treating sex cord- stromal ovarian tumors. Methods. We conducted a retrospecti...Objective. We compared the efficacy and side effects of taxanes, with or without platinum, to bleomycin, etoposide, and cisplatin (BEP) in treating sex cord- stromal ovarian tumors. Methods. We conducted a retrospective review of all patients with sex cord- stromal ovarian tumors seen at our institution from 1985 to 2002. Eligible patients were those who underwent pathologic confirmation, clinical evaluation, and treatment with a taxane or BEP for initial or recurrent disease. Results. Of 222 patients identified, 21 received BEP for new (n=11) or recurrent disease (n=10); 44 received a taxane during 48 treatment episodes (four patients on two occasions each) for new (n = 11) or recurrent disease (n = 37). Newly diagnosed patients treated with BEP vs. taxanes had no significant difference in response rate (Fisher’s exact test, P =1), progression- free survival (PFS) (log- rank test, P=0.213), or overall survival (log- rank test, P=0.994). Among patients treated for recurrent measurable disease, the response rate was higher for BEP- treated (71% ) than for taxanetreated patients (37% ), but this was not statistically significant. In all patients treated for recurrent disease, there was no significant difference in failure to progress at chemotherapy completion between BEP- (70% ) and taxane- treated patients (62% ) or in median PFS (11.2 vs. 7.2 months). The presence of platinum in taxanecontain- ing regimens correlated with response. Taxane related side effects included neutropenia (n = 6), anemia (n = 1), thrombocytopenia (n = 1), myelodysplasia (n = 1), and hypersensitivity (n = 1). BEP- related side effects included pulmonary fibrosis (n = 3) and neutropenia (n = 2). Conclusions. Taxanes demonstrated activity against sex cord- stromal tumors of the ovary and may be less toxic than BEP. Taxane and platinum combination chemotherapy warrants further investigation in this disease.展开更多
文摘Objective. We compared the efficacy and side effects of taxanes, with or without platinum, to bleomycin, etoposide, and cisplatin (BEP) in treating sex cord- stromal ovarian tumors. Methods. We conducted a retrospective review of all patients with sex cord- stromal ovarian tumors seen at our institution from 1985 to 2002. Eligible patients were those who underwent pathologic confirmation, clinical evaluation, and treatment with a taxane or BEP for initial or recurrent disease. Results. Of 222 patients identified, 21 received BEP for new (n=11) or recurrent disease (n=10); 44 received a taxane during 48 treatment episodes (four patients on two occasions each) for new (n = 11) or recurrent disease (n = 37). Newly diagnosed patients treated with BEP vs. taxanes had no significant difference in response rate (Fisher’s exact test, P =1), progression- free survival (PFS) (log- rank test, P=0.213), or overall survival (log- rank test, P=0.994). Among patients treated for recurrent measurable disease, the response rate was higher for BEP- treated (71% ) than for taxanetreated patients (37% ), but this was not statistically significant. In all patients treated for recurrent disease, there was no significant difference in failure to progress at chemotherapy completion between BEP- (70% ) and taxane- treated patients (62% ) or in median PFS (11.2 vs. 7.2 months). The presence of platinum in taxanecontain- ing regimens correlated with response. Taxane related side effects included neutropenia (n = 6), anemia (n = 1), thrombocytopenia (n = 1), myelodysplasia (n = 1), and hypersensitivity (n = 1). BEP- related side effects included pulmonary fibrosis (n = 3) and neutropenia (n = 2). Conclusions. Taxanes demonstrated activity against sex cord- stromal tumors of the ovary and may be less toxic than BEP. Taxane and platinum combination chemotherapy warrants further investigation in this disease.
