| Ning Li,Yutao Gao,Wei Zhang,Xiaoguang Li,Bin Li,Haimei Tian,Yanfen Li,Lingying Wu. Comparative analysis of ATP-based tumor chemosensitivity assay-directed chemotherapy versus physician-decided chemotherapy in platinum-resistant recurrent ovarian cancer. Oncol Transl Med, 2017, 3: 225-230. |
| ATP-TCA体外药敏检测指导治疗与经验治疗在铂耐药复发卵巢癌中的比较研究 |
| Comparative analysis of ATP-based tumor chemosensitivity assay-directed chemotherapy versus physician-decided chemotherapy in platinum-resistant recurrent ovarian cancer |
| Received:October 02, 2017 Revised:December 07, 2017 |
| DOI：10.1007/s10330-017-0241-1 |
| 中文关键词: 卵巢上皮癌、化疗耐药、复发、ATP-TCA |
| 英文关键词: epithelial ovarian cancer; platinum-resistance; recurrence; ATP-based tumor chemosensitivity assay (ATP-TCA) |
| 基金项目:首都临床特色应用研究 |
| Author Name | Affiliation | E-mail | | Ning Li | Department of Gynecological Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China | liningnci@126.com | | Yutao Gao | Department of Gynecological Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China | | | Wei Zhang | Biological Testing Center, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China | | | Xiaoguang Li | Department of Gynecological Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China | | | Bin Li | Department of Gynecological Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China | | | Haimei Tian | Biological Testing Center, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China | | | Yanfen Li | Cancer Hospital, Chinese Academy of Medical Sciences | | | Lingying Wu* | Department of Gynecological Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China | wulingying@csco.org.cn |
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| 中文摘要: |
| 目的 评价三磷酸腺苷肿瘤药物敏感性检测技术(ATP-TCA)在铂耐药复发卵巢癌中指导化疗方案选择的作用。
方法 收集43例在中国医学科学院肿瘤医院收治的铂耐药复发卵巢癌者，参考ATP-TCA结果进行化疗。另外选择同时期收治、与ATP-TCA组患者具有相同临床病理特征、根据主管医生经验进行治疗的铂耐药复发卵巢癌43例，作为对照组。采用Log-rank和Cox比例风险模型进行统计分析。
结果 共86例患者纳入研究，常规随访定期复查，比较无进展生存期（PFS）。中位随访时间为13个月。ATP-TCA组和对照组的PFS分别为5个月和3个月（P=0.027）。多因素分析显示，不同治疗组是PFS的独立预后因素(P=0.040; HR 0.623; 95% CI: 0.313~0.973)。亚组分析表明，无治疗间隔（TFI）≥3个月的患者中（n=50），ATP-TCA组患者的PFS明显长于对照组（7个月 vs 4个月，P=0.010）。在既往化疗方案数≤ 2的患者中，与对照组相比，ATP-TCA组患者的PFS亦明显延长（6个月vs 4个月，P=0.025）。
结论 ATP-TCA指导化疗可能有助于延长铂耐药复发患者的PFS，尤其是TFI≥3个月或者既往化疗方案数≤ 2者，可能从ATP-TCA指导治疗中获益更多。 |
| 英文摘要: |
| Objective The aim of the study was to evaluate the role of ATP-based tumor chemosensitivity assay
(ATP-TCA) in patients with platinum-resistant recurrent ovarian cancer (PRROC).
Methods A total of 43 patients with PRROC who underwent chemotherapy based on the results of ATPTCA
in the Cancer Hospital, Chinese Academy of Medical Sciences were included in the present study. As
controls, we selected another 43 patients with PRROC who were treated at the physician’s discretion within
the same time period and had the same clinical characteristics as the patients in the ATP-TCA group. Logrank
test and Cox proportional hazards model were adopted for analysis.
Results A total of 86 patients were retrospectively analyzed in the present study. Patients were routinely
monitored to evaluate the rate of progression-free survival (PFS). The median follow-up time was 13
months. The PFS for the ATP-TCA and control groups was 5 and 3 months, respectively (P = 0.027).
Multivariate analysis showed that the type of treatment was an independent prognostic factor for PFS (P =
0.040; HR: 0.623; 95% CI: 0.313–0.973). Subgroup analysis showed that among patients with a treatmentfree
interval (TFI) of ≥ 3 months (n = 50), those in the ATP-TCA group had longer PFS than those in the
control group (7 vs 4 months, P = 0.010). Meanwhile, the median PFS of patients who underwent ≤ 2 prior
chemotherapy regimens (PCR, n = 52) in the ATP-TCA and control groups was 6 months and 4 months,
respectively (P = 0.025).
Conclusion ATP-TCA-directed chemotherapy might improve the PFS in PRROC. In particular, the
survival benefit from ATP-TCA is higher in patients with a TFI of ≥ 3 months or treated with ≤ 2 PCR. |
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