Oxaliplatin-based combination chemotherapy is still effective for the treatment of recurrent and platinum-resistant epithelial ovarian cancer: results from a single center

摘要

Background Combination paclitaxel and carboplatin is currently a first-line regimen for ovarian cancer.However,many patients develop tumor recurrence or drug resistance to this regimen.The study aims to investigate the effectiveness and safety of an oxaliplatin + epirubicin + ifosfamide regimen for the treatment of recurrent and drug-resistant epithelial ovarian cancer.Methods A retrospective analysis of 73 patients with recurrent and drug-resistant ovarian cancer was performed; 38 cases of them received oxaliplatin + epirubicin + ifosfamide regimens (lAP group),35 patients received non-oxaliplatinbased chemotherapy regimens (control group).The therapeutic effects and side effects of the oxaliplatin + epirubicin + ifosfamide regimen were analyzed and summarized.Kaplan-Meier survival curves and Cox proportional hazards regression were used to compare progression-free and overall survival between the two groups.Results Of the 38 patients in the lAP group,14 patients (36.84％) achieved complete remission,12 (31.58％) achieved partial remission,2 (5.26％) achieved stable disease and 10 (26.32％) developed progressive disease.The overall effective rate (complete or partial remission) of the lAP regime was 68.42％.While,of the 35 patients in the control group,12 patients (34.29％) achieved complete remission,3 (8.57％) achieved partial remission,5 (14.29％) achieved stable disease and 15 (42.86％) developed progressive disease.The overall effective rate was 42.86％,which was lower than that in the lAP group (P=0.035,X2=4.836).Progression-free survival was 9.5 months (0-64 months) in the lAP group vs.3 months (0-74 months) in the non-oxaliplatin group (P=0.014 by Kaplan-Meier survival curves; HR=-2.260; 95％C/1.117-4.573; P=0.023 by Cox proportional hazards regression).Median overall survival was 46 months (9-124 months)in the lAP group vs.35 months (9-108 months) in non-oxaliplatin group (P=0.018 by Kaplan-Meier survival curves;HR=2.272; 95％CI 1.123-4.598; P=0.022 by Cox proportional hazards regression).In lAP group,15.79％ (6/38)of the patients suffered grade Ⅲ-Ⅳ bone marrow arrest.The main non-hematological side effects of the lAP regimen included nausea and vomiting (21.05％,8/38),peripheral neurotoxicity (15.79％,6/38) and hepatic or renal lesions (2.63％,1/38).The main side effects of the two chemotherapy regimens showed no statistical difference.Conclusion The oxaliplatin-based lAP regimen is potentially effective for salvage chemotherapy in patients with recurrent and drug-resistant ovarian cancer,with a better therapeutic effect and tolerable side effects.