Useanddurationofchemotherapyanditsimpact解说.ppt

Use and duration of chemotherapy and its impact on survival in early-stage ovarian cancer化疗的使用和周期对早期卵巢癌的生存期的影响 Helen E.Dinkelspiel,Ana I.Tergas,et al Department of Obstetrics and Gynecology,Columbia University College of Physicians and Surgeons,USA Gynecologic Oncology137(2015)203-209 Use and duration of chemotherapy and its impact on survival in early-stage ovarian cancer化疗的使用和持续时间对早期卵巢癌的生存期的影响 Helen E.Dinkelspiel,Ana I.Tergas,et al Gynecologic Oncology137(2015)203-209 HIGHLIGHTS Among early-stage ovarian cancer patients practice patterns are widely divergent. 在早期卵巢癌病人的实际治疗中存在较大差异。 Extended duration chemotherapy does not appear to impact survival for women with high-risk disease. 长时间的化疗并没有明显改善高危患者的生存率。 ABSTRACT Objiective.Although 5-year survival for early-stage ovarian cancer is gnosis at recurrence is poor,necessitating appropriate initial management.We examined the patterns of care and the impact of the duration of chemotherapy on survival for women with early-stage ovarian cancer. 目的：虽然早期卵巢癌的5年生存率较高，但是如果复发，则预后极差，需要适当的初始管理.我们研究了治疗方式和化疗的持续时间对早期卵巢癌患者的生存期的影响. ABSTRACT Methods.We used the SEER-Medicare database to identify women ≧65 years of age with stage I ovarian cancer diagnosed from 1992 to 2009.Patients were categorized as low-risk(non-clear cell histology,stage IA or IB,grade 1 or 2)or high-risk (clear cell histology,grade 3,or stage IC).We used muitivariable logistic regression models to determine predictors of chemotherapy use and duration and COX proportional hazards models to evaluate the effect of chemotherapy use and duration on survival.　 方法：我们用SEER-Medicare数据库，采选了从1992年到2009年，确诊为I期卵巢癌的≧65岁妇女。患者被分类为低危组（非透明细胞癌，分期是IA或IB，分级是1级或2级）和高危组（透明细胞癌，分级3级，或分期IC）。我们用多变量Logistic回归模型，以确定化疗药物的使用和持续时间的预测，以及Cox比例风险模型来评估化疗药物的使用和持续时间对生存的影响。 ABSTRACT Results.We identified 1394 patients.Among low-risk patients,32.9% received adjuvant chemotherapy and the use of chemotherapy increased with time.Among high-risk patients,71.9% received adjuvant chemotherapy;44.2%had≤3 months