在I期卵巢清细胞癌中辅助化疗:系统性审查和元分析
Yoshihide Inayama1, Nozomi Higashiyama, Ken Yamaguchi
1Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, the Department of Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, and the Graduate School of Medicine and Public Health and the Office of Institutional Advancement and Communications, Kyoto University, Kyoto; the Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, the Department of Obstetrics and Gynecology, Osaka Saiseikai Noe Hospital, Osaka, and the Department of Obstetrics and Gynecology, Kurashiki Central Hospital, Okayama, Japan.
辅助化疗显著改善无病生存率,并可能延长第一阶段卵巢清细胞癌患者的整体存活率. 随着治疗,复发风险降低了大约50%.
科学领域:
- 妇科瘤学 妇科瘤学
- 医学瘤学 医学瘤学
- 临床药理学 临床药理学
背景情况:
- 第一个阶段的卵巢清细胞癌 (OCCC) 提出了独特的治疗挑战.
- 在早期OCCC中辅助化疗的疗效需要详细的研究.
研究的目的:
- 在被诊断为I期OCCC的患者中评估辅助化疗的治疗效果.
- 评估辅助化疗对无病生存期 (DFS) 和整体生存期 (OS) 的影响.
主要方法:
- 在多个数据库 (Cochrane,PubMed等) 进行了全面的文献搜索. 在2025年1月之前.
- 来自9项非随机对照试验 (非RCT) 的危险比率 (HRs) 的元分析,涉及50多名患有I期OCCC的患者.
- 评估5年DFS和OS率,并计算需要治疗的数量 (NNT).
主要成果:
- 辅助化疗显示,DFS的合并次阶段调整HR为0.47,OS的合并次阶段调整HR为0.66.
- 在各次阶段之间没有观察到治疗效果的显著异质性.
- 聚合的5年DFS率总体为80%,NNTs表明显著的好处,特别是在IC阶段.
结论:
- 辅助化疗与在I阶段OCCC中改善DFS和潜在的OS益处有关.
- 这些发现表明,复发率大幅降低,约为50%.
- 治疗决策应纳入基线复发风险和辅助化疗的绝对益处.
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