Objective The aim of the study was to evaluate the role of ATP-based tumor chemosensitivity assay(ATP-TCA) in patients with platinum-resistant recurrent ovarian cancer(PRROC).Methods A total of 43 patients with PRROC ...Objective The aim of the study was to evaluate the role of ATP-based tumor chemosensitivity assay(ATP-TCA) in patients with platinum-resistant recurrent ovarian cancer(PRROC).Methods A total of 43 patients with PRROC who underwent chemotherapy based on the results of ATPTCA in the Cancer Hospital,Chinese Academy of Medical Sciences were included in the present study.As controls,we selected another 43 patients with PRROC who were treated at the physician's discretion within the same time period and had the same clinical characteristics as the patients in the ATP-TCA group.Logrank test and Cox proportional hazards model were adopted for analysis.Results A total of 86 patients were retrospectively analyzed in the present study.Patients were routinely monitored to evaluate the rate of progression-free survival(PFS).The median follow-up time was 13 months.The PFS for the ATP-TCA and control groups was 5 and 3 months,respectively(P = 0.027).Multivariate analysis showed that the type of treatment was an independent prognostic factor for PFS(P = 0.040;HR:0.623;95% CI:0.313–0.973).Subgroup analysis showed that among patients with a treatmentfree interval(TFI) of ≥ 3 months(n = 50),those in the ATP-TCA group had longer PFS than those in the control group(7 vs 4 months,P = 0.010).Meanwhile,the median PFS of patients who underwent ≤ 2 prior chemotherapy regimens(PCR,n = 52) in the ATP-TCA and control groups was 6 months and 4 months,respectively(P = 0.025).Conclusion ATP-TCA-directed chemotherapy might improve the PFS in PRROC.In particular,the survival benefit from ATP-TCA is higher in patients with a TFI of ≥ 3 months or treated with ≤ 2 PCR.展开更多
目的探讨贝伐珠单抗联合TC(紫杉醇/卡铂)方案治疗晚期复发性卵巢癌患者的效果。方法选取2017年11月至2022年11月汉中市中心医院收治的92例复发性晚期卵巢癌患者进行随机对照试验,采用随机数字表法将其分为对照组和观察组,各46例。对照...目的探讨贝伐珠单抗联合TC(紫杉醇/卡铂)方案治疗晚期复发性卵巢癌患者的效果。方法选取2017年11月至2022年11月汉中市中心医院收治的92例复发性晚期卵巢癌患者进行随机对照试验,采用随机数字表法将其分为对照组和观察组,各46例。对照组年龄(52.34±8.45)岁,国际妇产科联盟(International Federation of Gynecology and Obstetrics,IFGO)分期Ⅲ期24例、Ⅳ期22例。观察组年龄(53.21±9.67)岁,FIGO分期Ⅲ期23例、Ⅳ期23例。对照组采用TC方案治疗,观察组在对照组基础上加用贝伐珠单抗治疗;两组均治疗6个周期,约18周。对比两组患者治疗后临床疗效、肿瘤血清标志物[糖类抗原125(carbohydrate antigen 125,CA125)、人附睾蛋白4(human epididymis protein 4,HE4)、糖类抗原199(carbohydrate antigen 199,CA199)、血管内皮生长因子(vascular endothelial growth factor,VEGF)]水平、治疗后1年生存率、生存质量[采用卡氏功能状态量表(Karnofsky Performance Status Scale,KPS)]评分和不良反应发生情况。采用t检验、χ^(2)检验。结果治疗6个周期后,观察组疾病缓解率为78.26%(36/46),高于对照组的54.35%(25/46)(χ^(2)=7.771,P=0.005);观察组CA125、HE4、CA199和VEGF水平均低于对照组(均P<0.05);观察组治疗后1年生存率为73.91%(34/46),高于对照组46.65%(21/46)(χ^(2)=7.640,P=0.006);观察组KPS评分为(72.52±8.13)分,高于对照组的(64.60±7.58)分(t=4.832,P<0.001);两组主要不良反应为骨髓抑制、消化道反应和肝肾损伤;观察组与对照组各不良反应发生率相比,差异均无统计学意义(均P>0.05)。结论贝伐珠单抗联合TC方案治疗复发性晚期卵巢癌患者临床效果较好,可提高患者1年生存率和生活质量,降低肿瘤血清标志物水平,且不良反应可控。展开更多
目的：系统评价肿瘤细胞减灭术联合腹腔内热灌注化疗在晚期及复发性上皮性卵巢癌中应用的疗效。方法：采用计算机检索Cochrane图书馆、Pub Med、Embase、美国临床肿瘤（American Society of Clinical Oncology,ASCO）和欧洲肿瘤内科学会...目的：系统评价肿瘤细胞减灭术联合腹腔内热灌注化疗在晚期及复发性上皮性卵巢癌中应用的疗效。方法：采用计算机检索Cochrane图书馆、Pub Med、Embase、美国临床肿瘤（American Society of Clinical Oncology,ASCO）和欧洲肿瘤内科学会（European Society for Medical Oncology,ESMO）、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、万方数据库,时间为1998年1月至2014年11月,纳入肿瘤细胞减灭术联合腹腔内热灌注化疗与传统方法比较治疗晚期及复发性上皮性卵巢癌的临床对照试验,由2名评价者独立按NOS标准评价纳入观察性研究的质量,按Cochrane偏倚风险评估工具评价纳入随机对照试验的质量,并采用Cochrane协作网提供的Rev Man 5.3软件进行Meta分析,合并值为风险比（HR）。结果：纳入9项研究共731例患者,其中1项为随机对照研究,其余8项为观察性研究,Meta分析结果显示,与传统治疗相比,肿瘤细胞减灭术联合腹腔内热灌注化疗能够延长晚期及复发性卵巢癌的无疾病生存期（HR=0.39,95%CI 0.27~0.56）及总生存期（HR=0.39,95%CI 0.29~0.53）,差异有统计学意义。结论：目前的证据表明,CRS联合HIPEC能够改善晚期及复发性上皮性卵巢癌的生存期,但由于观察性研究固有的缺陷,其疗效仍需要大型、多中心、前瞻性的随机对照试验来验证,因此就目前的证据来说,建议对CRS联合HIPEC的临床应用持审慎的态度。展开更多
目的观察白蛋白结合型紫杉醇联合卡铂治疗晚期、复发性上皮卵巢癌的近期疗效和安全性。方法选取86例晚期、复发性上皮卵巢癌患者,随机分成2组。对照组采用溶剂型紫杉醇联合卡铂治疗,观察组采用白蛋白结合型紫杉醇联合卡铂治疗,21天为1...目的观察白蛋白结合型紫杉醇联合卡铂治疗晚期、复发性上皮卵巢癌的近期疗效和安全性。方法选取86例晚期、复发性上皮卵巢癌患者,随机分成2组。对照组采用溶剂型紫杉醇联合卡铂治疗,观察组采用白蛋白结合型紫杉醇联合卡铂治疗,21天为1个疗程,6个疗程后对治疗的有效性进行评价。结果观察组患者客观缓解率高于对照组(51.16%vs30.23%),差异存在统计学意义(P<0.05),观察组中位生存时间高于对照组(6.8月vs3.6月),死亡例数少于对照组(3例vs5例),差异均有统计学意义(P<0.05)。化疗后,观察组患者生活质量改善率优于对照组(60.47% vs 41.86%),差异有统计学意义(P<0.05)。结论白蛋白结合型紫杉醇联合卡铂治疗晚期、复发性上皮卵巢癌近期疗效较好,不良反应能耐受,值得临床上推广。展开更多
基金Supported by a grant from the Capital’s Funds for Health Improvement and Research(No.Z131107002213013)
文摘Objective The aim of the study was to evaluate the role of ATP-based tumor chemosensitivity assay(ATP-TCA) in patients with platinum-resistant recurrent ovarian cancer(PRROC).Methods A total of 43 patients with PRROC who underwent chemotherapy based on the results of ATPTCA in the Cancer Hospital,Chinese Academy of Medical Sciences were included in the present study.As controls,we selected another 43 patients with PRROC who were treated at the physician's discretion within the same time period and had the same clinical characteristics as the patients in the ATP-TCA group.Logrank test and Cox proportional hazards model were adopted for analysis.Results A total of 86 patients were retrospectively analyzed in the present study.Patients were routinely monitored to evaluate the rate of progression-free survival(PFS).The median follow-up time was 13 months.The PFS for the ATP-TCA and control groups was 5 and 3 months,respectively(P = 0.027).Multivariate analysis showed that the type of treatment was an independent prognostic factor for PFS(P = 0.040;HR:0.623;95% CI:0.313–0.973).Subgroup analysis showed that among patients with a treatmentfree interval(TFI) of ≥ 3 months(n = 50),those in the ATP-TCA group had longer PFS than those in the control group(7 vs 4 months,P = 0.010).Meanwhile,the median PFS of patients who underwent ≤ 2 prior chemotherapy regimens(PCR,n = 52) in the ATP-TCA and control groups was 6 months and 4 months,respectively(P = 0.025).Conclusion ATP-TCA-directed chemotherapy might improve the PFS in PRROC.In particular,the survival benefit from ATP-TCA is higher in patients with a TFI of ≥ 3 months or treated with ≤ 2 PCR.
文摘目的探讨贝伐珠单抗联合TC(紫杉醇/卡铂)方案治疗晚期复发性卵巢癌患者的效果。方法选取2017年11月至2022年11月汉中市中心医院收治的92例复发性晚期卵巢癌患者进行随机对照试验,采用随机数字表法将其分为对照组和观察组,各46例。对照组年龄(52.34±8.45)岁,国际妇产科联盟(International Federation of Gynecology and Obstetrics,IFGO)分期Ⅲ期24例、Ⅳ期22例。观察组年龄(53.21±9.67)岁,FIGO分期Ⅲ期23例、Ⅳ期23例。对照组采用TC方案治疗,观察组在对照组基础上加用贝伐珠单抗治疗;两组均治疗6个周期,约18周。对比两组患者治疗后临床疗效、肿瘤血清标志物[糖类抗原125(carbohydrate antigen 125,CA125)、人附睾蛋白4(human epididymis protein 4,HE4)、糖类抗原199(carbohydrate antigen 199,CA199)、血管内皮生长因子(vascular endothelial growth factor,VEGF)]水平、治疗后1年生存率、生存质量[采用卡氏功能状态量表(Karnofsky Performance Status Scale,KPS)]评分和不良反应发生情况。采用t检验、χ^(2)检验。结果治疗6个周期后,观察组疾病缓解率为78.26%(36/46),高于对照组的54.35%(25/46)(χ^(2)=7.771,P=0.005);观察组CA125、HE4、CA199和VEGF水平均低于对照组(均P<0.05);观察组治疗后1年生存率为73.91%(34/46),高于对照组46.65%(21/46)(χ^(2)=7.640,P=0.006);观察组KPS评分为(72.52±8.13)分,高于对照组的(64.60±7.58)分(t=4.832,P<0.001);两组主要不良反应为骨髓抑制、消化道反应和肝肾损伤;观察组与对照组各不良反应发生率相比,差异均无统计学意义(均P>0.05)。结论贝伐珠单抗联合TC方案治疗复发性晚期卵巢癌患者临床效果较好,可提高患者1年生存率和生活质量,降低肿瘤血清标志物水平,且不良反应可控。
文摘目的：系统评价肿瘤细胞减灭术联合腹腔内热灌注化疗在晚期及复发性上皮性卵巢癌中应用的疗效。方法：采用计算机检索Cochrane图书馆、Pub Med、Embase、美国临床肿瘤（American Society of Clinical Oncology,ASCO）和欧洲肿瘤内科学会（European Society for Medical Oncology,ESMO）、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、万方数据库,时间为1998年1月至2014年11月,纳入肿瘤细胞减灭术联合腹腔内热灌注化疗与传统方法比较治疗晚期及复发性上皮性卵巢癌的临床对照试验,由2名评价者独立按NOS标准评价纳入观察性研究的质量,按Cochrane偏倚风险评估工具评价纳入随机对照试验的质量,并采用Cochrane协作网提供的Rev Man 5.3软件进行Meta分析,合并值为风险比（HR）。结果：纳入9项研究共731例患者,其中1项为随机对照研究,其余8项为观察性研究,Meta分析结果显示,与传统治疗相比,肿瘤细胞减灭术联合腹腔内热灌注化疗能够延长晚期及复发性卵巢癌的无疾病生存期（HR=0.39,95%CI 0.27~0.56）及总生存期（HR=0.39,95%CI 0.29~0.53）,差异有统计学意义。结论：目前的证据表明,CRS联合HIPEC能够改善晚期及复发性上皮性卵巢癌的生存期,但由于观察性研究固有的缺陷,其疗效仍需要大型、多中心、前瞻性的随机对照试验来验证,因此就目前的证据来说,建议对CRS联合HIPEC的临床应用持审慎的态度。
文摘目的观察白蛋白结合型紫杉醇联合卡铂治疗晚期、复发性上皮卵巢癌的近期疗效和安全性。方法选取86例晚期、复发性上皮卵巢癌患者,随机分成2组。对照组采用溶剂型紫杉醇联合卡铂治疗,观察组采用白蛋白结合型紫杉醇联合卡铂治疗,21天为1个疗程,6个疗程后对治疗的有效性进行评价。结果观察组患者客观缓解率高于对照组(51.16%vs30.23%),差异存在统计学意义(P<0.05),观察组中位生存时间高于对照组(6.8月vs3.6月),死亡例数少于对照组(3例vs5例),差异均有统计学意义(P<0.05)。化疗后,观察组患者生活质量改善率优于对照组(60.47% vs 41.86%),差异有统计学意义(P<0.05)。结论白蛋白结合型紫杉醇联合卡铂治疗晚期、复发性上皮卵巢癌近期疗效较好,不良反应能耐受,值得临床上推广。
