| Title | POJAVNOST MAKROCITOZE TIJEKOM PRVOLINIJSKOG LIJEČENJA EPITELNOG RAKA JAJNIKA SPOJEVIMA PLATINE I PAKLITAKSELOM |
| Author | Toni Boban |
| Mentor(s) | Tihana Boraska Jelavić (thesis advisor)
|
| Abstract | CILJ ISTRAŽIVANJA: Ispitati kliničku opservaciju da pacijentice sa epitelnim rakom jajnika, liječene kombinacijom spojeva platine i paklitaksela, razvijaju makrocitozu i istražiti moguću prediktivnu ulogu makrocitoze na odgovor na terapiju, period bez progresije bolesti i ukupno preživljenje.
MATERIJALI I METODE: Provedena je retrospektivna analiza laboratorijskih i kliničkih podataka pacijentica liječenih u jednom onkološkom centru u periodu od 2004.-2015. godine. Pacijentice s epitelnim rakom jajnika FIGO IC i više, liječene prvolinijskim TC-protokolom i sa kompletnim laboratorijskim krvnim pretragama su bile pogodne za analizu. Makrocitoza je definirana kao porast srednjeg volumena eritrocita (MCV) iz periferne krvi preko 97.2 fL za vrijeme trajanja kemoterapije, ili unutar 30 dana od aplikacije zadnjeg kemoterapijskog ciklusa.
REZULTATI: Ukupno je 184 pacijentica uključeno u studiju. Među njima je 141 pacijentica liječena trotjednim TC-protokolom, a 43 pacijentice "dose dense" protokolom (sol platine prvi dan svaka tri tjedna i paklitaksel prvi dan svaki tjedan). Makrocitoza je inducirana u ukupno 35% pacijentica. Inducirana je značajno češće u pacijentica liječenih "dose dense" protokolom (67% vs 26%, p=1.29x10-6). Makrocitoza nije povezana s odgovorom na terapiju, periodom bez progresije bolesti i ukupnim preživljenjem u ukupnoj populaciji pacijentica, kao ni u skupini liječenoj trotjednim TC-protokolom. Ali, značajno je povezana sa periodom bez progresije bolesti u skupini liječenoj "dose dense" protokolom (21 mjesec vs 16 mjeseci, p=0.036, HR=2.4, 95%CI=1.06-5.42) kao i sa odgovorom na terapiju (100% vs 70%, p=0.0285).
ZAKLJUČAK: TC "dose dense" protokol inducira makrocitozu značajno više nego trotjedni TC-protokol kod pacijentica sa epitelnim rakom jajnika. U pacijentica liječenih "dose dense" protokolom, makrocitoza može biti prediktivni čimbenik duljeg perioda bez progresije bolesti i objektivnog odgovora na terapiju. Ovom nalazu je potrebna potvrda prospektivne studije na većem broju pacijentica. |
| Keywords | Ovarian Neoplasms Anemia Macrocytic Antineoplastic Combined Chemotherapy Protocols Platinum Compounds Paclitaxel |
| Parallel title (English) | INCIDENCE OF MACROCYTOSIS IN FIRST-LINE TREATMENT OF EPITHELIAN OVARIAN CANCER WITH PLATINUM COMPOUNDS AND PACLITAXEL |
| Granter | University of Split
School of Medicine |
| Lower level organizational units | Clinical oncology |
| Place | Split |
| State | Croatia |
| Scientific field, discipline, subdiscipline | BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Oncology
|
| Study programme type | university |
| Study level | integrated undergraduate and graduate |
| Study programme | Medicine |
| Academic title abbreviation | dr. med. |
| Genre | master's thesis |
| Language | Croatian |
| Defense date | 2016 |
| Parallel abstract (English) | OBJECTIVE: To investigate a clinical observation that patients with epithelial ovarian cancer treated with first-line platinum salt-paclitaxel chemotherapy combination (TP) develop macrocytosis and to explore possible predictive role of macrocytosis on response rate (RR), progression- free survival (PFS) and overall survival (OS).
MATERIALS AND METODS: Retrospective analysis of laboratory and clinical data of ovarian cancer patients treated in a single oncology center from 2004. till 2015. was conducted. Patients diagnosed with epithelial ovarian cancer FIGO stage IC or higher, treated with first-line TP chemotherapy and with complete blood count records available were eligible for analysis. Macrocytosis was defined as an increase of mean corpuscular volume (MCV) of peripheral red blood cells above 97.2 fl during the treatment and/or 30 days after the last chemotherapy cycle.
RESULTS: A total of 184 patients were enrolled in this study. Amongst them, 141 patients were treated with conventional 3-weekly schedule, while 43 patients were treated with dose-dense schedule (platinum salt on day 1 every 3 weeks and paclitaxel on day 1 every week). Macrocytosis was induced in 35% of patients overall. It was induced significantly more often in patients treated with dose-dense than 3- weekly schedule (67% vs 26%, p=1.29 x 10-6). Macrocytosis was not correlated with RR, PFS and OS in overall patient population, nor in patients treated with 3- weekly schedule. It was significantly correlated with PFS in patients treated with dose-dense schedule (median PFS of 21 months (MCV≥97.2) vs 16 months (MCV<97.2); p=0.036, HR=2.4, 95%CI=1.06-5.42) and with response rate (100% vs 70%, p=0.0285).
CONCLUSIONS: Combination chemotherapy with TP in ovarian cancer patients induces macrocytosis significantly more often in those treated with dose-dense than 3-weekly schedule. In patients treated with dose-dense schedule it can be predictive for longer PFS and positive response rate. This finding needs confirmation on a larger group of patients in a prospective study. |
| Parallel keywords (Croatian) | Novotvorine jajnika Makrocitna anemija Protokoli protutumorske kombinirane kemoterapije Spojevi platine Paklitaksel |
| Resource type | text |
| Access condition | Open access |
| Terms of use |  |
| URN:NBN | https://urn.nsk.hr/urn:nbn:hr:171:388649 |
