上皮性卵巢癌患者手术后血清CA-125回归正常时间及生存时间与化疗敏感性的关系  

Association of the timing of normalization of CA-125 levels with survival and chemotherapy sensitivity in epithelial ovarian cancer patients

作　　者：于明新[1] 王兴玲[1] 

机构地区：[1]辽宁省肿瘤医院妇二科,沈阳110042

出　　处：《中国肿瘤临床与康复》2013年第7期677-680,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨上皮性卵巢癌(EOC)手术后规范化疗期间血清CA-125回归正常时间、无进展生存时间(PFS)与化疗疗效的关系。方法选取98例例接受初次肿瘤细胞减灭术联合铂和(或)紫衫类一线化疗后达到临床完全缓解的EOC患者入组。随访观察患者在每个化疗周期CA-125值变化、铂基础化疗的敏感性(末次化疗结束起PFS>6个月为铂敏感)和PFS。按照第三化疗周期血清CA-125回归正常与否分为C3-N组(73例)和C3-AN组(25例)。结果 C3-N组患者的PFS为27.7个月,C3-AN组为15.4个月,差异有统计学意义(P<0.001);C3-N组患者铂基础化疗敏感性为95.8,C3-AN组为56.0%,差异有统计学意义(P<0.001)。按照减瘤状态进行亚组分析,非理想减瘤状态下C3-N组PFS为22.3个月,C3-AN组为11.3个月,差异有统计学意义(P<0.001);而理想减瘤状态下两组PFS(25.0个月和20.9个月)差异无统计学意义(P=0.611)。化疗1～6个周期患者血清CA-125回归正常的铂敏感性从95.0%下降到33.0%(P<0.001)。结论卵巢癌患者术后血清CA-125回归正常时间与生存及铂基础化疗敏感性相关,血清CA-125回归正常时间越早的患者,具有更好的PFS及更高的铂敏感性。Objective To determine the relationships between the timing of normalization of CA-125 levels and progression-free survival（PFS）,chemotherapy response in epithelial ovarian cancer（EOC）.Methods Observational study of clinical data on 98 patients who reached a complete clinical response for EOC with primary taxane/platinum-based chemotherapy.Patient demographics,CA-125 levels,and survival outcomes were Abstracted.Progression free survival（PFS） and platinum sensitivity（6 months from chemotherapy completion） were compared to CA-125 levels during primary therapy.Results 98 patients who achieved a complete clinical response were identified.Patients who achieved normalization of CA-125 by 3rd cycle of chemotherapy or not were grouped as C3-N and C3-AN separately.Group C3-N were compared to group C3-AN.Group C3-N demonstrated improved PFS（（27.7 vs 15.4,P0.001））,and platinum sensitivity（95.8 vs 56.0%,P0.001）.This survival advantage was maintained when patients were evaluated by suboptimal debulking status,while not by optimal debulking status.Additionally,when stratified by the specific cycle patients＇ achieved normalization,platinum sensitivity decreased from 95.0% to 33.0%（P0.001）.Conclusions The timing of normalization of CA-125 levels was associated with survival and chemotherapy response.Earlier normalization of CA-125 levels during primary chemotherapy for EOC predicts improvement in PFS and platinum sensitivity.

关 键 词：上皮性卵巢癌 CA-125 生存 铂敏感 

分 类 号：R737.31[医药卫生—肿瘤]