晚期卵巢癌老年女性选择何种治疗?让历史数据告诉我们
MedSci · 2015/12/20
研究者进行了一项研究,评估美国晚期卵巢癌患者的总生存率是否在日益改善。研究结果表明,晚期卵巢癌老年女性,通过优化治疗可使其得到最佳生存。当无法进行优化治疗时,只进行化疗也比只手术治疗有更好的生存!


研究者进行了一项研究,评估美国晚期卵巢癌患者的总生存率是否在日益改善。该回顾性队列研究评估了1995-2008年间美国、>65岁、诊断为Ⅲ、Ⅳ期卵巢癌女性的治疗和总生存趋势。研究者使用参数和半参数多变量生存分析评估不同治疗下的存活率以及影响生存和复发的因素。

该研究共纳入7938名患者,其中2.9%未接受治疗,15.4%只进行了手术,24.8%只进行了化疗,41.8%进行了减瘤手术,然后在最佳时间进行化疗,15.1%的患者进行了减瘤手术,但化疗时机不是最佳的或者没有完成完整的6周期化疗。

研究数据显示,只进行手术治疗的患者其生存时间与不治疗组相似(2.2个月 vs. 1.7个月),只进行化疗的患者总生存较好(14.4个月)。优化治疗可最大限度延长生存时间(P<.001,中位数总生存为39.0个月)。另外在过去的10年与优化治疗相关生存时间也在延长。不过在过去的10年,进行优化治疗的比例在下降。

研究结果表明,晚期卵巢癌老年女性,通过优化治疗可使其得到最佳生存。当无法进行优化治疗时,只进行化疗也比只手术治疗有更好的生存!

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  • Ovarian Cancer Treatment and Survival Trends Among Women Older Than 65 Years of Age in the United States, 1995-2008.

    OBJECTIVE: To evaluate whether overall survival is improving among women in the United States with advanced ovarian cancer. METHODS: This retrospective cohort study evaluated trends in treatment and overall survival for women older than 65 years diagnosed with stage III and IV epithelial ovarian cancer between 1995 and 2008 using Surveillance, Epidemiology, and End Results-Medicare data. Parametric and semiparametric multivariate survival analyses were used to assess comparative treatment survival rates and factors affecting survival and recurrence. RESULTS: Of 7,938 women who met study criteria, 2.9% received no treatment, 15.4% underwent surgery only, 24.8% received chemotherapy only, 41.8% underwent primary debulking surgery and chemotherapy in an optimal timeframe, and 15.1% had primary debulking surgery and chemotherapy, but the timing was not optimal or patients did not complete all six cycles of chemotherapy. Those who underwent surgery only had similar survival as those who received no treatment (2.2 compared with 1.7 months), whereas those who received chemotherapy only had a better overall survival (14.4 months). Optimal treatment was associated with the longest survival time (P<.001, median overall survival 39.0 months). Additionally, survival time associated with optimal treatment increased over the past decade. However, the proportion of women who received optimal treatment has decreased over the past decade. CONCLUSION: Elderly women with advanced ovarian cancer have the best survival with optimal therapy. When this is not offered or possible, chemotherapy alone offers better survival than surgery alone.

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