铂类敏感型复发性卵巢癌不同治疗方案疗效比较研究OACSTPCD

Objective:Through retrospective case analysis of 132 platinum-sensitive recurrent ovarian cancer(PSROC)cases in the Cancer Hospital Affiliated to Guangxi Medical University,this study aimed to investigate the effects of different clinical characteristics on the overall survival(OS)of PSROC patients,explore the factors affecting the survival of PSROC patients and the impact of different treatment options on the prognosis of PSROC patients,so as to optimize the treatment of recurrent ovarian cancer.Methods:The clinical data,including relapse age,FIGO stage,histopathological type,platinum-free intervals(PFI),CA125 at recurrence,recurrent lesions and ascites,of 132 PSROC patients with electronic medical re-cords from the Cancer Hospital Affiliated to Guangxi Medical University from July 2010 to August 2018 were collected to ex-plore the factors affecting the survival of PSROC patients and construct a prognostic prediction model.Results:Univariate a-nalysis showed that PFI,CA125 at recurrence,recurrent lesions and ascites were correlated to OS in PSROC patients(P＜0.05);relapse age,FIGO stage and histopathological type were not correlated to OS(P＞0.05).COX multivariate analysis showed that PFI,CA125 at recurrence and recurrent lesions are independent risk factors for the prognosis of PSROC patients(P＜0.05).The nomogram of the prognosis prediction model can be used to predict the survival probability of PSROC pa-tients at different times.The follow-up time of PSROC patients in this study ranged from 2 to 108 months,with a median fol-low-up time of 33.5 months.The median OS were 51.0 and 29.0 months in the secondary cytoreductive surgery(SCS)group and chemotherapy alone group(HR=0.45,95％CI:0.27～0.77,P=0.003);the median OS in the former was 22 months longer than that in the latter,and the difference was statistically significant(P＜0.05).The median OS were 55.0 and 36.0 months in the residual tumor lesion＜1 cm group and the residual tumor lesion ≥1 cm group(HR=0.40,95％CI:0.18～0.89,P=0.024);the median OS in the former was 19 months longer than that in the latter,and the difference was statistically significant(P＜0.05).The median OS were 38.0 and 56.0 months in the secondary neoadjuvant chemother-apy(SNACT)+SCS group and the direct SCS group(HR=2.02,95％CI:0.95～4.29,P=0.066);and there were similar OS in the two groups.The median OS in cisplatin/carboplatin-based chemotherapy group and other platinum-based chemo-therapy group were 49.0 and 30.5 months,respectively(HR=0.62,95％CI:0.41～0.95,P=0.029);the median OS in the former was 18.5 months longer than that in the latter,and the difference was statistically significant(P＜0.05).The me-dian OS were 35.0 and 49.0 months in the cisplatin/carboplatin+vascular inhibitor group and the cisplatin/carboplatin group,respectively(HR=1.52,95％CI:0.65～3.57,P=0.332);the median OS in the latter was 14 months longer than that in the former,and the difference was not statistically significant(P＞0.05).The median OS were 29.5,42.0 and 38.0 months in the treatment course＜4 group,the 4～6 treatment course group and the treatment course＞6 group,respectively(HR=0.74,95％CI:0.41～1.34,P=0.053);and there was no statistically significant difference among the three groups(P＞0.05).Conclusion:For PSROC patients,a satisfactory second operation brings significant survival benefits to the pa-tients.For patients who cannot directly undergo a second operation,SNACT may be an alternative treatment.Combination chemotherapy containing cisplatin or carboplatin is still the first choice for PSROC patients.