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RISS 인기검색어
- 검색키워드
- 저자 : Barbara A. Goff (검색결과 3 건)
- 무료
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Advanced ovarian cancer: what should be the standard of care?
Barbara A. Goff 대한부인종양학회 2013 Journal of Gynecologic Oncology Vol.24 No.1
The standard treatment of advanced ovarian cancer is rapidly changing. As we begin to understand that epithelial ovarian cancer is a heterogeneous disease, our treatment strategies are evolving to include novel biologic drugs that specifically exploit altered pathways. Surgery remains an essential component in the treatment of ovarian cancer; however, the importance of surgical specialization and defining “optimal cytoreduction” as no visible residual disease has been further validated. Ongoing studies are defining the role of neoadjuvant chemotherapy in the upfront treatment of advanced ovarian cancer. In addition,clinical trials are evaluating intraperitoneal, dose dense, antiangiogenic drugs as well as targeted maintenance therapies which will establish new standards of care in the near future.
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Tilley Jenkins Vogel,Abhay Knickerbocker,Chirag A. Shah,Melissa A. Schiff,Christina Isacson,Rochelle L. Garcia,Barbara A. Goff 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.1
Objective: Despite the rarity of uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC), theycontribute disproportionately to endometrial cancer deaths. Sufficient clinical information regarding treatment and prognosis islacking. The aim of this study is to evaluate treatment outcomes in a rare cancer cohort based on the experience at two tertiarycare cancer centers. Methods: Clinicopathologic data were retrospectively collected on 279 patients with UPSC and UCCC treated between 1995 to2011. Mode of surgery, use of adjuvant treatment, and dissection of paraaoritc lymph nodes were evaluated for their associationwith overall survival (OS) and progression-free survival (PFS). Results: 40.9% of patients presented with stage I disease, 6.8% of patients presented with stage II disease and 52.3% of patientspresented with stages III and IV. Median follow-up was 31 months (range, 1 to 194 months). OS and PFS at 5 years were 63.0%and 51.9%, respectively. OS and PFS were not affected by mode of surgery (open vs. robotic approach; OS: hazard ratio [HR], 0.68;95% confidence interval [CI], 0.28 to 1.62; PFS: HR, 0.78; 95% CI, 0.40 to 1.56). Adjuvant treatment was associated with improvedOS in stages IB-II (HR, 0.14; 95% CI, 0.02 to 0.78; p=0.026) but not in stage IA disease. There was no difference in OS or PFS basedon the performance of a paraaoritc lymph node dissection. Conclusion: Minimally invasive surgical staging appears a reasonable strategy for patients with non-bulky UPSC and UCCC andwas not associated with diminished survival. Adjuvant treatment improved 5-year survival in stages IB-II disease.
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Jovana Y. Martin,Renata R. Urban,John B. Liao,Barbara A. Goff 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.5
Objective: Bevacizumab was recently approved by the US Food and Drug Administration foruse in recurrent platinum resistant epithelial ovarian cancer (EOC), fallopian tube cancer(FTC), or primary peritoneal cancer (PPC) when no more than two prior cytotoxic regimenshave been used; due to concerns for gastrointestinal perforation. We sought to determinebevacizumab-related toxicities in heavily pretreated recurrent EOC. Methods: We performed a retrospective chart review of patients with recurrent EOC, FTC,and PPC from 2001 to 2011. Patients who received at least two prior chemotherapy regimensbefore bevacizumab were included. Medical records were reviewed for bevacizumabassociated toxicities. The Wilcoxon-Mann-Whitney test was used to compare quantitativevariables. Survival was estimated with the Kaplan-Meier method. Results: Sixty patients met inclusion criteria. At the start of bevacizumab treatment, themedian age was 60 years and the median body mass index was 26.5 kg/m2. More than 50%of patients received bevacizumab after three prior cytotoxic regimens. Grade 3 or higherbevacizumab associated toxicity events occurred in four patients, including one patient whodeveloped a rectovaginal fistula. The median overall survival from the start of bevacizumabtreatment was 21.05 months (95% CI, 18.23 to 32.67; range, 1.9 to 110 months). The numberof cytotoxic regimens prior to bevacizumab treatment did not differ in those that experienceda toxicity versus those that did not (p=0.66). Conclusion: The use of bevacizumab in heavily pretreated EOC, FTC, or PPC is worthconsideration.
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