时间问题:手术到化疗的间隔以及卵巢癌的结果
Yoav Siegler1, Avia Omer2, Yasmin Yousef2
1Department of Obstetrics & Gynecology, Rambam Health Care Center, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
European journal of obstetrics, gynecology, and reproductive biology
|October 15, 2025
概括
在手术后28天内开始化疗可能会改善卵巢癌患者的整体存活率. 这种益处在晚期病例和接受间隔细胞减小手术的人群中更为明显.
科学领域:
- 妇科瘤学 妇科瘤学
- 卵巢癌研究研究 卵巢癌研究
- 手术瘤学手术瘤学
背景情况:
- 表皮卵巢癌 (EOC) 治疗通常涉及细胞减少手术,随后是辅助化疗.
- 手术后开始化疗的最佳时间尚未确定.
- 辅助化疗旨在消除残留疾病并防止复发.
研究的目的:
- 评估从细胞还原手术到辅助化疗启动的时间间隔之间的关联,以及在上皮卵巢癌中治疗结果.
- 为了确定更短的化疗时间 (TTC) 是否与改善的整体存活率 (OS) 和无进展存活率 (PFS) 相相关.
主要方法:
- 对197名患有高度上皮卵巢癌的患者进行了回顾性队列研究 (2011-2023年).
- 患者接受了原发性或间歇性细胞减小手术,并接受了基于的化疗 (碳波/帕克利塔塞尔),可选的是贝瓦西祖马布或奥拉帕里布.
- 化学疗法 (TTC) 的时间分为≤28,≤35和≤42天. 使用危险比率分析了OS和PFS.
主要成果:
- 平均生存期为29.5个月,平均PFS为15.1个月.
- 在TTC ≤28天与>28天 (HR 1.54,p=0.06) 的情况下,观察到改善OS的趋势.
- 亚组分析显示,IIIA-IVB阶段疾病患者 (HR 1.80) 和接受间隔细胞减小手术 (HR 2.5) 的患者的生存状况显著改善.
结论:
- 在细胞减小手术后28天内开始化疗可能会提高卵巢癌患者的整体存活率.
- 这种时间表对于患有晚期疾病 (IIIA-IVB) 和接受间歇细胞减小手术的患者来说尤其有益.
- 需要进一步的前性研究来证实这些发现并优化治疗顺序.
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