Asian Pacific Journal of Cancer Prevention

  • 제16권6호
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  • Pages.2369-2373
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  • 2015
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  • 1513-7368(pISSN)
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  • 2476-762X(eISSN)
아시아태평양암예방학회 (Asian Pacific Journal of Cancer Prevention)
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Role of Neoadjuvant Chemotherapy in the Management of Advanced Ovarian Cancer

  • Zhao, Dan (Department of Gynecology Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
  • Wu, Ling-Ying (Department of Gynecology Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
  • Wang, Xiao-Bing (Medical Center for Tumor Detection, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
  • Li, Xiao-Guang (Department of Gynecology Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College)
  • 발행 : 2015.04.03
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초록

Objective: To analyze efficacy of neoadjuvant chemotherapy for advanced ovarian cancer. Materials and Methods: A total of 107 patients with advanced ovarian cancer undergoing cytoreductive surgery were divided into a neoadjuvant chemotherapy group (n=61) and a primary debulking group (n=46) and retrospectively analyzed. Platinum-based adjuvant chemotherapy was applied to both groups after cytoreductive surgery ande overall and progression-free survival times were calculated. Results: No significant difference was observed in duration of hospitalization ($20.8{\pm}6.1$ vs. $20.2{\pm}5.4$ days, p>0.05). The operation time of neoadjuvant chemotherapy group was shorter than the initial surgery group ($3.1{\pm}0.7$ vs. $3.4{\pm}0.8$ h, p<0.05). There were no significant differences in median overall survival time between neoadjuvant chemotherapy group and surgery group (42 vs. 55 months, p>0.05). Similarly, there was no difference in median progression-free survival between neoadjuvant chemotherapy group and surgery group (16 vs. 17 months, p>0.05). The surgical residual tumor size demonstrated no significant difference between initial surgery and neoadjuvant chemotherapy groups (p>0.05). Multivariate analysis showed that more than 3 cycles of regimen with neoadjuvant chemotherapy was associated with more resistance to chemotherapy compared with patients without receiving neoadjuvant chemotherapy (OR: 5.962, 95%CI: 1.184-30.030, p<0.05). Conclusions:Neoadjuvant chemotherapy can shorten the operation time. However, it does not improve survival rates of advanced ovarian cancer patients.

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참고문헌

  1. Akita H, Doki Y, Yano M, et al (2009). Effects of neoadjuvant chemotherapy on primary tumor and lymph node metastasis in esophageal squamous cell carcinoma: additive association with prognosis. Dis Esophagus, 22, 291-7. https://doi.org/10.1111/j.1442-2050.2008.00879.x
  2. Bian J, Li B, Kou XJ, et al (2014). Clinical applicability of multi-tumor marker protein chips for diagnosing ovarian cancer. Asian Pac J Cancer Prev, 15, 8409-11. https://doi.org/10.7314/APJCP.2014.15.19.8409
  3. Bristow RE, Chi DS (2006). Platinum-based neoadjuvant chemotherapy and interval surgical cytoreduction for advanced ovarian cancer: a meta-analysis. Gynecol Oncol, 103, 1070-6. https://doi.org/10.1016/j.ygyno.2006.06.025
  4. Chan YM, Ng TY, Ngan HY, et al (2003). Quality of life in women treated with neoadjuvant chemotherapy for advanced ovarian cancer: a prospective longitudinal study. Gynecol Oncol, 88, 9-16. https://doi.org/10.1006/gyno.2002.6849
  5. Dewdney SB, Rimel BJ, Reinhart AJ, et al (2010). The role of neoadjuvant chemotherapy in the management of patients with advanced stage ovarian cancer: survey results from members of the society of gynecologic oncologists. Gynecol Oncol, 119, 18-21. https://doi.org/10.1016/j.ygyno.2010.06.021
  6. Frei E, 3rd (1982). The National Cancer Chemotherapy Program. Science, 217, 600-6. https://doi.org/10.1126/science.7046055
  7. Gadducci A, Tana R, Landoni F, et al (2013). Analysis of failures and clinical outcome of advanced epithelial ovarian cancer in patients with microscopic residual disease at second-look reassessment following primary cytoreductive surgery and first-line platinum-based chemotherapy. Eur J Gynaecol Oncol, 34, 213-7.
  8. Inciura A, Simavicius A, Juozaityte E, et al (2006). Comparison of adjuvant and neoadjuvant chemotherapy in the management of advanced ovarian cancer: a retrospective study of 574 patients. BMC Cancer, 6, 153. https://doi.org/10.1186/1471-2407-6-153
  9. Lawton FG, Redman CW, Luesley DM, et al (1989). Neoadjuvant (cytoreductive) chemotherapy combined with intervention debulking surgery in advanced, unresected epithelial ovarian cancer. Obstet Gynecol, 73, 61-5.
  10. Le T, Hopkins L, Faught W, et al (2007). The lack of significance of Ca125 response in epithelial ovarian cancer patients treated with neoadjuvant chemotherapy and delayed primary surgical debulking. Gynecol Oncol, 105, 712-5. https://doi.org/10.1016/j.ygyno.2007.02.022
  11. Loizzi V, Cormio G, Resta L, et al (2005). Neoadjuvant chemotherapy in advanced ovarian cancer: a case-control study. Int J Gynecol Cancer, 15, 217-23. https://doi.org/10.1111/j.1525-1438.2005.15206.x
  12. Mazzeo F, Berliere M, Kerger J, et al (2003). Neoadjuvant chemotherapy followed by surgery and adjuvant chemotherapy in patients with primarily unresectable, advanced-stage ovarian cancer. Gynecol Oncol, 90, 163-9. https://doi.org/10.1016/S0090-8258(03)00249-X
  13. McCluggage WG, Lyness RW, Atkinson RJ, et al (2002). Morphological effects of chemotherapy on ovarian carcinoma. J Clin Pathol, 55, 27-31. https://doi.org/10.1136/jcp.55.1.27
  14. McGuire WP, Hoskins WJ, Brady MF, et al (1996). Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer. N Engl J Med, 334, 1-6. https://doi.org/10.1056/NEJM199601043340101
  15. Monk BJ, Dalton H, Farley JH, et al (2013). Antiangiogenic agents as a maintenance strategy for advanced epithelial ovarian cancer. Crit Rev Oncol Hematol, 86, 161-75. https://doi.org/10.1016/j.critrevonc.2012.09.012
  16. Rosen B, Laframboise S, Ferguson S, et al (2014). The impacts of neoadjuvant chemotherapy and of debulking surgery on survival from advanced ovarian cancer. Gynecol Oncol, 134, 462-7. https://doi.org/10.1016/j.ygyno.2014.07.004
  17. Schwartz PE, Chambers JT, Makuch R (1994). Neoadjuvant chemotherapy for advanced ovarian cancer. Gynecol Oncol, 53, 33-7. https://doi.org/10.1006/gyno.1994.1083
  18. Schwartz PE, Rutherford TJ, Chambers JT, et al (1999). Neoadjuvant chemotherapy for advanced ovarian cancer: long-term survival. Gynecol Oncol, 72, 93-9. https://doi.org/10.1006/gyno.1998.5236
  19. Sternberg CN, Raghaven D, Ohi Y, et al (1995). Neoadjuvant and adjuvant chemotherapy in advanced disease--what are the effects on survival and prognosis? Int J Urol, 2, 76-88. https://doi.org/10.1111/j.1442-2042.1995.tb00482.x
  20. Tatematsu N, Ezoe Y, Tanaka E, et al (2013). Impact of neoadjuvant chemotherapy on physical fitness, physical activity, and health-related quality of life of patients with resectable esophageal cancer. Am J Clin Oncol, 36, 53-6. https://doi.org/10.1097/COC.0b013e3182354bf4
  21. Vergote I, Trope CG, Amant F, et al (2010). Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med, 363, 943-53. https://doi.org/10.1056/NEJMoa0908806