THE EFFECT OF PROLONGED CISPLATIN-BASED CHEMOTHERAPY ON PROGRESSION-FREE SURVIVAL IN PATIENTS WITH OPTIMAL EPITHELIAL OVARIAN-CANCER - MAINTENANCE THERAPY RECONSIDERED

被引:32
作者
GERSHENSON, DM
MITCHELL, MF
ATKINSON, N
SILVA, EG
KAVANAGH, JJ
MORRIS, M
BURKE, TW
WARNER, D
WHARTON, JT
机构
[1] UNIV TEXAS,MD ANDERSON CANC CTR,DEPT GYNECOL,HOUSTON,TX 77030
[2] UNIV TEXAS,MD ANDERSON CANC CTR,DEPT BIOMATH,HOUSTON,TX 77030
[3] UNIV TEXAS,MD ANDERSON CANC CTR,DEPT PATHOL,HOUSTON,TX 77030
关键词
D O I
10.1016/0090-8258(92)90067-S
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
From 1978 until 1988, 116 patients with epithelial ovarian cancer were entered onto one of three consecutive prospective clinical trials involving cisplatin-based combination chemotherapy. They had the following characteristics: (1) stage III or IV disease, (2) grade 2 or 3 tumors, and (3) optimally debulked tumors (residual disease ≤2 cm). The purpose of the study was to investigate the influence of duration of chemotherapy on survival. The treatment plans were as follows: Trial 1, 12 cycles of cisplatin/melphalan (43 patients); Trial 2, 12 cycles of cisplatin/cyclophosphamide (24 patients); and Trial 3, 6 cycles of cisplatin/cyclophosphamide (49 patients). The total dose of cisplatin was 60 mg/m2 in the first trial and 50 mg/m2 in the second and third trials. Median survival times for the three groups were 58, 29, and 35 months, respectively (NS). Median progression-free survival (PFS) times were 37, 23, and 15 months, respectively (P = 0.0008). Combining patients from the first two trials, the median PFS for patients receiving 12 planned cycles of chemotherapy was 30 months versus 15 months for patients receiving 6 planned cycles (P = 0.0004). Using a forward stepwise Cox proportional hazard model, the use of 12 cycles of therapy and melphalan predicted increased PFS (P = 0.0001 and P = 0.0002, respectively). In view of these results, the lack of published data supporting the superiority of 6 over 12 cycles of chemotherapy, and the rather recent availability of less toxic maintenance therapy (i.e., carboplatin), we believe that a multiinstitutional trial comparing the 6-cycle regimen with more prolonged chemotherapy is justifiable. © 1992.
引用
收藏
页码:7 / 13
页数:7
相关论文
共 26 条
[1]  
[Anonymous], 1990, SPSS REFERENCE GUIDE
[2]   SURVIVAL CURVE FOR CANCER PATIENTS FOLLOWING TREATMENT [J].
BERKSON, J ;
GAGE, RP .
JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION, 1952, 47 (259) :501-515
[3]   A RANDOMIZED STUDY OF CYCLOPHOSPHAMIDE AND CISPLATINUM WITH OR WITHOUT DOXORUBICIN IN ADVANCED OVARIAN-CARCINOMA [J].
BERTELSEN, K ;
JAKOBSEN, A ;
ANDERSEN, JE ;
AHRONS, S ;
PEDERSEN, PH ;
KIAER, H ;
ARFFMANN, E ;
BICHEL, P ;
BOESTOFTE, E ;
CHRISTOPHERSEN, IS ;
GREGERSEN, E ;
HANSEN, MK ;
HOLUND, B ;
JACOBSEN, M ;
JENSEN, HK ;
JEPSEN, FL ;
LARSEN, G ;
NIELSEN, ES ;
NYLAND, M ;
OLSEN, J ;
PANDURO, J ;
RANK, F ;
SELL, A ;
SOGAARD, H .
GYNECOLOGIC ONCOLOGY, 1987, 28 (02) :161-169
[4]  
BERTELSEN K, 1989, P AN M AM SOC CLIN, V8, P150
[5]   IMPROVING THE QUALITY-OF-LIFE DURING CHEMOTHERAPY FOR ADVANCED BREAST-CANCER - A COMPARISON OF INTERMITTENT AND CONTINUOUS TREATMENT STRATEGIES [J].
COATES, A ;
GEBSKI, V ;
BISHOP, JF ;
JEAL, PN ;
WOODS, RL ;
SNYDER, R ;
TATTERSALL, MHN ;
BYRNE, M ;
HARVEY, V ;
GILL, G ;
SIMPSON, J ;
DRUMMOND, R ;
BROWNE, J ;
VANCOOTEN, R ;
FORBES, JF .
NEW ENGLAND JOURNAL OF MEDICINE, 1987, 317 (24) :1490-1495
[6]   A RANDOMIZED TRIAL COMPARING CISPLATIN PLUS CYCLOPHOSPHAMIDE VERSUS CISPLATIN, DOXORUBICIN, AND CYCLOPHOSPHAMIDE IN ADVANCED OVARIAN-CANCER [J].
CONTE, PF ;
BRUZZONE, M ;
CHIARA, S ;
SERTOLI, MR ;
DAGA, MG ;
RUBAGOTTI, A ;
CONIO, A ;
RUVOLO, M ;
ROSSO, R ;
SANTI, L ;
CARNINO, F ;
COTTINI, M ;
MOSSETTI, C ;
GUERCIO, E ;
GATTI, M ;
SILIQUINI, PN ;
PRELATO, ML ;
DURANDO, C ;
GIACCONE, G ;
CALCIATI, A ;
FARININI, D ;
CENTONZE, M ;
RUGIATI, S ;
PARODI, G ;
MESSINEO, M ;
STORACE, A ;
BERNARDINI, G ;
MISURALE, F ;
ALESSANDRI, S ;
CASINI, M ;
RAGNI, N ;
FOGLIA, G ;
BENTIVOGLIO, G ;
PESCETTO, G .
JOURNAL OF CLINICAL ONCOLOGY, 1986, 4 (06) :965-971
[7]  
Day T G Jr, 1975, Natl Cancer Inst Monogr, V42, P15
[8]   TREATMENT OF ADVANCED EPITHELIAL OVARIAN-CANCER WITH CISPLATIN AND CYCLOPHOSPHAMIDE [J].
GERSHENSON, DM ;
WHARTON, JT ;
COPELAND, LJ ;
STRINGER, CA ;
EDWARDS, CL ;
KAVANAGH, JJ ;
FREEDMAN, RS .
GYNECOLOGIC ONCOLOGY, 1989, 32 (03) :336-341
[9]  
GRECO FA, 1981, OBSTET GYNECOL, V58, P199
[10]   MELPHALAN MAY BE A MORE POTENT LEUKEMOGEN THAN CYCLOPHOSPHAMIDE [J].
GREENE, MH ;
HARRIS, EL ;
GERSHENSON, DM ;
MALKASIAN, GD ;
MELTON, LJ ;
DEMBO, AJ ;
BENNETT, JM ;
MOLONEY, WC ;
BOICE, JD .
ANNALS OF INTERNAL MEDICINE, 1986, 105 (03) :360-367