新辅助化疗治疗晚期上皮性卵巢癌的现状探讨
A Review of the Status of Neoadjuvant Chemotherapy for Advanced Epithelial Ovarian Cancer
摘要: 晚期上皮性卵巢癌(epithelial ovarian cancer, EOC)是常见的女性生殖系统恶性肿瘤,因死亡率高而臭名远扬。我国及国际指南推荐的晚期上皮性卵巢癌治疗标准是初始肿瘤细胞减灭术(primary debulking surgery, PDS)后辅以化疗。由于部分晚期上皮性卵巢癌患者初诊时伴随内科合并症多且严重、肿瘤负荷大、瘤体累及范围大等情况,导致PDS无法达到满意的减瘤效果或无法行手术治疗。迄今为止,许多研究结果表明新辅助化疗(neoadjuvant chemotherapy, NACT)后行间歇性肿瘤减灭术(internal debulking surgery, IDS)的生存结局不亚于PDS联合含铂化疗。因此,NACT-IDS可能是晚期EOC的一种替代治疗方案。随着NACT在晚期上皮性卵巢癌治疗应用,新辅助化疗的疗效及适应证成为了妇科肿瘤学家争论的热门话题。本文旨在探讨新辅助化疗治疗晚期上皮性卵巢癌的现状,并进一步探讨NACT的疗效及适应症。
Abstract: Advanced epithelial ovarian cancer is a common malignant tumor of the female reproductive sys-tem and is notorious for its high mortality rate. The standard of treatment for advanced epithelial ovarian cancer recommended by our national and international guidelines is primary debulking surgery (PDS) followed by chemotherapy. As some patients with advanced epithelial ovarian cancer are accompanied by many serious medical comorbidities, large tumor load, and extensive tumor involvement at the time of initial diagnosis, PDS fails to achieve a satisfactory tumor reduction effect or prevents surgical treatment. Many findings to date have demonstrated that neoadjuvant chem-otherapy (NACT) followed by internal debulking surgery (IDS) has a survival outcome no less fa-vorable than PDS combined with platinum-containing chemotherapy. Thus, NACT-IDS is probably an alternative treatment option for advanced EOC. With the therapeutic application of NACT in the treatment of advanced epithelial ovarian cancer, the efficacy and indications for neoadjuvant chemotherapy have become a hot topic of debate among gynecologic oncologists. The purpose of this article is to discuss the current status of neoadjuvant chemotherapy for advanced epithelial ovarian cancer and to discuss further the efficacy and indications for NACT.
文章引用:阿斯曼姑丽·阿伍提, 阿比达·阿布都卡德尔. 新辅助化疗治疗晚期上皮性卵巢癌的现状探讨[J]. 临床医学进展, 2024, 14(1): 2236-2243. https://doi.org/10.12677/ACM.2024.141313

参考文献

[1] 单冬勇, 成树林, 马邺晨, 等. 上皮性卵巢癌血清中肿瘤标志物水平及其临床意义(英文) [J]. 中南大学学报(医学版), 2023, 48(7): 1039-1049.
[2] Saner, F.A.M., Ruggeri, G., Siegenthaler, F., Wampfler, J., Imboden, S. and Mueller, M.D. (2023) Change of Fagotti Score Is Associated with Outcome after Neoadjuvant Chemotherapy for Ovari-an Cancer. International Journal of Gynecological Cancer, 33, 1595-1601. [Google Scholar] [CrossRef] [PubMed]
[3] 朱秀红, 毛翠玉, 张燕, 等. 卵巢癌新辅助化疗的研究进展[J]. 现代妇产科进展, 2023, 32(11): 865-869.
[4] 付小玲, 郭哲, 唐旭. 晚期卵巢癌新辅助化疗中应用紫杉醇联合铂类改良剂量密集型疗法对患者卵巢血流参数、肿瘤标志物水平、生存情况的影响[J]. 实用癌症杂志, 2023, 38(4): 686-688, 693.
[5] Jakob, D., Schmoor, C., Reuten, R., Frevert, M.L., Dannehl, D., Jansen, L., Hermann, S., Jung-mann, P., Hartkopf, A.D., Juhasz-Böss, I. and Taran, F.A. (2023) Characteristics, Treatment Patterns and Survival of In-ternational Federation of Gynecology and Obstetrics Stage IV Epithelial Ovarian Cancer—A Population-Based Study. Cancers, 15, Article 5676. [Google Scholar] [CrossRef] [PubMed]
[6] 卢淮武, 叶栋栋, 吴斌, 等. 《2023 NCCN卵巢癌包括输卵管癌及原发性腹膜癌临床实践指南(第1版)》解读[J]. 中国实用妇科与产科杂志, 2023, 39(1): 58-67.
[7] 袁航, 张师前, 李小平, 等. 晚期上皮性卵巢癌新辅助化疗指征的快速指南(2021年版) [J]. 中国实用妇科与产科杂志, 2021, 37(4): 444-448.
[8] Griffiths, C.T. (1975) Surgical Resection of Tumor Bulk in the Primary Treatment of Ovarian Car-cinoma. National Cancer Institute Monograph, 42, 101-104.
[9] Bryant, A., Hiu, S., Kunonga, P.T., Gajjar, K., Craig, D., Vale, L., Winter-Roach, B.A., Elattar, A. and Naik, R. (2022) Impact of Residual Disease as a Prognostic Factor for Survival in Women with Advanced Epithelial Ovarian Cancer after Primary Surgery. The Cochrane Database of System-atic Reviews, 9, CD015048. [Google Scholar] [CrossRef
[10] 卢淮武, 许妙纯, 张钰豪, 等. 《2021 NCCN卵巢癌包括输卵管癌及原发性腹膜癌临床实践指南(第1版)》解读[J]. 中国实用妇科与产科杂志, 2021, 37(4): 457-466.
[11] Colombo, N., Sessa, C., Bois, A.D., Ledermann, J., McCluggage, W.G., McNeish, I., Morice, P., Pignata, S., Ray-Coquard, I., Vergote, I., Baert, T., Belaroussi, I., Dashora, A., Olbrecht, S., Planchamp, F., Querleu, D. and ESMO-ESGO Ovarian Cancer Consensus Conference Working Group (2019) ESMO-ESGO Consensus Confer-ence Recommendations on Ovarian Cancer: Pathology and Molecular Biology, Early and Advanced Stages, Borderline Tumours and Recurrent Disease. International Journal of Gynecological Cancer, 29, 728-760. [Google Scholar] [CrossRef] [PubMed]
[12] Armstrong, D.K., Alvarez, R.D., Bakkum-Gamez, J.N., Barroilhet, L., Behbakht, K., Berchuck, A., Chen, L.M., Cristea, M., DeRosa, M., Eisenhauer, E.L., Gershenson, D.M., Gray, H.J., Grisham, R., Hakam, A., Jain, A., Karam, A., Konecny, G.E., Leath, C.., Liu, J., Mahdi, H., Engh, A.M., et al. (2021) Ovarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehen-sive Cancer Network, 19, 191-226. [Google Scholar] [CrossRef] [PubMed]
[13] Vergote, I., Tropé, C.G., Amant, F., Kristensen, G.B., Ehlen, T., Johnson, N., Verheijen, R.H., van der Burg, M.E., Lacave, A.J., Panici, P.B., Kenter, G.G., Casado, A., Mendiola, C., Coens, C., Verleye, L., Stuart, G.C., Pecorelli, S., Reed, N.S., European Organization for Research and Treatment of Cancer-Gynaecological Cancer Group and NCIC Clinical Trials Group (2010) Neoadjuvant Chemotherapy or Primary Surgery in Stage IIIC or IV Ovarian Cancer. The New England Journal of Medicine, 363, 943-953. [Google Scholar] [CrossRef
[14] 王泽华, 蔡晶. 妇科肿瘤新辅助化疗: 用好则好用[J]. 中国实用妇科与产科杂志, 2023, 39(7): 673-676.
[15] Fagotti, A., Ferrandina, G., Vizzielli, G., Fanfani, F., Gallotta, V., Chian-tera, V., Costantini, B., Margariti, P.A., Gueli Alletti, S., Cosentino, F., Tortorella, L. and Scambia, G. (2016) Phase III Randomised Clinical Trial Comparing Primary Surgery versus Neoadjuvant Chemotherapy in Advanced Epithelial Ovar-ian Cancer with High Tumour Load (SCORPION Trial): Final Analysis of Peri-Operative Outcome. European Journal of Cancer, 59, 22-33. [Google Scholar] [CrossRef] [PubMed]
[16] Onda, T., Satoh, T., Saito, T., Kasamatsu, T., Nakanishi, T., Naka-mura, K., Wakabayashi, M., Takehara, K., Saito, M., Ushijima, K., Kobayashi, H., Kawana, K., Yokota, H., Takano, M., Takeshima, N., Watanabe, Y., Yaegashi, N., Konishi, I., Kamura, T., Yoshikawa, H. and Japan Clinical Oncology Group (2016) Comparison of Treatment Invasiveness between Upfront Debulking Surgery versus Interval Debulking Surgery following Neoadjuvant Chemotherapy for Stage III/IV Ovarian, Tubal, and Peritoneal Cancers in a Phase III Randomised Trial: Japan Clinical Oncology Group Study JCOG0602. European Journal of Cancer, 64, 22-31. [Google Scholar] [CrossRef] [PubMed]
[17] Tzanis, A.A., Iavazzo, C., Hadjivasilis, A., Tsouvali, H., Antoniou, G.Α. and Antoniou, S.A. (2022) Neoadjuvant Chemotherapy versus Primary Debulking Surgery in FIGO Stage III and IV Epithelial Ovarian, Tubal or Peritoneal Cancer: A Systematic Review and Meta-Analysis. Oncology Reviews, 16, Ar-ticle 10605. [Google Scholar] [CrossRef] [PubMed]
[18] Coleridge, S.L., Bryant, A., Kehoe, S. and Morrison, J. (2021) Chem-otherapy versus Surgery for Initial Treatment in Advanced Ovarian Epithelial Cancer. The Cochrane Database of Sys-tematic Reviews, 2, CD005343. [Google Scholar] [CrossRef
[19] Coleridge, S.L., Bryant, A., Kehoe, S. and Morrison, J. (2021) Neoadjuvant Chemotherapy before Surgery versus Surgery Followed by Chemotherapy for Initial Treatment in Advanced Ovarian Epithelial Cancer. The Cochrane Database of Systematic Reviews, 7, CD005343. [Google Scholar] [CrossRef
[20] Bartels, H.C., Rogers, A.C., McSharry, V., McVey, R., Walsh, T., O’Brien, D., Boyd, W.D. and Brennan, D.J. (2019) A Meta-Analysis of Morbidity and Mortality in Primary Cytoreductive Surgery Compared to Neoadjuvant Chemotherapy in Advanced Ovarian Malignancy. Gynecologic Oncol-ogy, 154, 622-630. [Google Scholar] [CrossRef] [PubMed]
[21] 牛星燕, 张冬萍, 李飞霞, 等. 卵巢恶性肿瘤化疗研究进展[J]. 国际妇产科学杂志, 2020, 47(2): 125-128.
[22] Coada, C.A., Dondi, G., Ravegnini, G., Di Costanzo, S., Tesei, M., Fiuzzi, E., Di Stanislao, M., Giunchi, S., Zamagni, C., Bovicelli, A., Hrelia, P., Angelini, S., De Iaco, P. and Perrone, A.M. (2023) Optimal Number of Neoadjuvant Chemotherapy Cycles Prior to Interval Debulking Surgery in Advanced Epithelial Ovarian Cancer: A Systematic Review and Meta-Analysis of Progression-Free Survival and Overall Survival. Journal of Gynecologic Oncology, 34, e82. [Google Scholar] [CrossRef] [PubMed]
[23] Marchetti, C., Rosati, A., De Felice, F., Boccia, S.M., Vertechy, L., Pavone, M., Palluzzi, E., Scambia, G. and Fagotti, A. (2021) Optimizing the Number of Cycles of Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Carcinoma: A Propensity-Score Matching Analysis. Gynecologic Oncology, 163, 29-35. [Google Scholar] [CrossRef] [PubMed]
[24] Kumari, A., Thakur, M., Saha, S.C., Suri, V., Prasad, G.R.V., Patel, F.D. and Radhika, S. (2021) To Compare the Optimal Cytoreduction Rate in Advanced Epithelial Ovarian Cancer Stage III/IV after 3 versus 6 Cycles of Neoadjuvant Chemotherapy. Journal of Obstetrics and Gynaecology, 41, 616-620. [Google Scholar] [CrossRef] [PubMed]
[25] Perrone, A.M., Coada, C.A., Ravegnini, G., De Leo, A., Damiano, G., De Crescenzo, E., Tesei, M., Di Costanzo, S., Genovesi, L., Rubino, D., Zamagni, C. and De Iaco, P. (2023) Post-Operative Residual Disease and Number of Cycles of Neoadjuvant Chemotherapy in Advanced Ep-ithelial Ovarian Carcinoma. International Journal of Gynecological Cancer, 33, 1270-1278. [Google Scholar] [CrossRef] [PubMed]
[26] Pieterse, Z., Amaya-Padilla, M.A., Singomat, T., Binju, M., Madjid, B.D., Yu, Y. and Kaur, P. (2019) Ovarian Cancer Stem Cells and Their Role in Drug Resistance. The International Journal of Biochemistry & Cell Biology, 106, 117-126. [Google Scholar] [CrossRef] [PubMed]
[27] Leary, A., Cowan, R., Chi, D., Kehoe, S. and Nankivell, M. (2016) Primary Surgery or Neoadjuvant Chemotherapy in Advanced Ovarian Cancer: The Debate Continues… American Society of Clinical Oncology Educational Book, 35, 153-162. [Google Scholar] [CrossRef
[28] Liu, J., Jiao, X. and Gao, Q. (2020) Neoadjuvant Chemotherapy-Related Platinum Resistance in Ovarian Cancer. Drug Discov-ery Today, 25, 1232-1238. [Google Scholar] [CrossRef] [PubMed]
[29] Vergote, I., Amant, F., Kristensen, G., Ehlen, T., Reed, N.S. and Casado, A. (2011) Primary Surgery or Neoadjuvant Chemotherapy Followed by Interval Debulking Surgery in Advanced Ovarian Cancer. European Journal of Cancer, 47, S88-S92. [Google Scholar] [CrossRef
[30] Wu, J., Zhou, T., Wang, Y., Jiang, Y. and Wang, Y. (2021) Mechanisms and Advances in Anti-Ovarian Cancer with Natural Plants Component. Molecules, 26, Article 5949. [Google Scholar] [CrossRef] [PubMed]
[31] Margioula-Siarkou, C., Petousis, S., Papanikolaou, A., Gullo, G., Margioula-Siarkou, G., Laganà, A.S., Dinas, K. and Guyon, F. (2022) Neoadjuvant Chemotherapy in Advanced-Stage Ovarian Cancer—State of the Art. Przeglad Menopauzalny, 21, 272-275. [Google Scholar] [CrossRef] [PubMed]
[32] Rouzier, R., Gouy, S., Selle, F., Lambaudie, E., Floquet, A., Four-chotte, V., Pomel, C., Colombo, P.E., Kalbacher, E., Martin-Francoise, S., Fauvet, R., Follana, P., Lesoin, A., Lecuru, F., Ghazi, Y., Dupin, J., Chereau, E., Zohar, S., Cottu, P. and Joly, F. (2017) Efficacy and Safety of Bevaci-zumab-Containing Neoadjuvant Therapy followed by Interval Debulking Surgery in Advanced Ovarian Cancer: Results from the ANTHALYA Trial. European Journal of Cancer, 70, 133-142. [Google Scholar] [CrossRef] [PubMed]
[33] Garcia Garcia, Y., de Juan Ferré, A., Mendiola, C., Barreti-na-Ginesta, M.P., Gaba Garcia, L., Santaballa Bertrán, A., Bover Barcelo, I., Gil-Martin, M., Manzano, A., Rubio Pérez, M.J., Romeo Marin, M., Arqueros Núñez, C., García-Martínez, E. and Gonzalez Martin, A. (2019) Efficacy and Safety Results from GEICO 1205, a Randomized Phase II Trial of Neoadjuvant Chemotherapy with or without Bevacizumab for Advanced Epithelial Ovarian Cancer. International Journal of Gynecological Cancer, 29, 1050-1056. [Google Scholar] [CrossRef] [PubMed]
[34] Nag, S., Aggarwal, S., Rauthan, A. and Warrier, N. (2022) Mainte-nance Therapy for Newly Diagnosed Epithelial Ovarian Cancer—A Review. Journal of Ovarian Research, 15, Article No. 88. [Google Scholar] [CrossRef] [PubMed]
[35] Goh, J.C.H., Gourley, C., Tan, D.S.P., Nogueira-Rodrigues, A., Elghazaly, H., Edy Pierre, M., Giornelli, G., Kim, B.G., Morales-Vasquez, F. and Tyulyandina, A. (2022) Optimizing Treatment Selection and Sequencing Decisions for First-Line Maintenance Therapy of Newly Diagnosed Advanced Ovarian Cancer. Gynecologic Oncology Reports, 42, Article ID: 101028. [Google Scholar] [CrossRef] [PubMed]
[36] Banerjee, S., Moore, K.N., Colombo, N., Scambia, G., Kim, B.G., Oaknin, A., Friedlander, M., Lisyanskaya, A., Floquet, A., Leary, A., Sonke, G.S., Gourley, C., Oza, A., Gonzá-lez-Martín, A., Aghajanian, C., Bradley, W.H., Holmes, E., Lowe, E.S. and Di Silvestro, P. (2021) Maintenance Olaparib for Patients with Newly Diagnosed Advanced Ovarian Cancer and a BRCA Mutation (SOLO1/GOG 3004): 5-Year Follow-Up of a Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial. The Lancet Oncology, 22, 1721-1731. [Google Scholar] [CrossRef
[37] Fasching, P.A., Link, T., Hauke, J., Seither, F., Jackisch, C., Klare, P., Schmatloch, S., Hanusch, C., Huober, J., Stefek, A., Seiler, S., Schmitt, W.D., Uleer, C., Doering, G., Rhiem, K., Schneeweiss, A., Engels, K., Denkert, C., Schmutzler, R.K., Hahnen, E., German Breast Group and Arbeitsgemeinschaft Gynäkologische Onkologie Breast (2021) Neoadjuvant Paclitaxel/Olaparib in Comparison to Paclitaxel/Carboplatinum in Patients with HER2-Negative Breast Cancer and Homologous Recombination Deficiency (GeparOLA Study). Annals of Oncology, 32, 49-57. [Google Scholar] [CrossRef] [PubMed]