頻回な血液検査によるCA125の測定は不必要な可能性がある (Abstract #: P1)

血中CA125レベル上昇に基づき治療を行っても症状発現を待って治療を行うのと再発性卵巣がん患者の生存率は変わらない
Treatment based on rising CA125 blood levels does not improve survival for recurrent ovarian cancer compared to waiting for symptoms to arise
血中CA125レベル上昇のみを指標に卵巣がんの再発に対し治療を早期に開始しても、症状発現まで治療を遅延させた場合と比較し全生存期間は変わらないとのヨーロッパの研究者らの報告が第45回American Society of Clinical Oncology学会で発表された。研究者らは、初回化学療法後に寛解しCA125上昇後にセカンドラインの化学療法を開始した患者265人と、CA125上昇後症状(骨盤痛や腫脹)が発現してから治療を開始した患者264人を比較した。早期治療開始群は治療遅延群よりも治療開始が5ヵ月早かったにもかかわらず、全生存期間は両群間で同等であり、ファーストライン化学療法終了後41ヵ月であった(ハザード比1.01、95% CI 0.82-1.25、p=0.91)。研究者らは、血清マーカーのみの上昇を基に早期治療を開始しても生存率の点では有益性はなく、したがって卵巣がん患者の経過観察におけるルーチンのCA125計測は有用でないと結論付けている。患者は症状発現後に治療を開始しても大丈夫である、と安心してよいようである。
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European researchers report that starting treatment early for an ovarian cancer relapse based on CA125 blood levels alone does not improve overall survival, compared with delaying treatment until symptoms arise.

"Women who've completed ovarian cancer treatment often worry about a relapse, and they undergo frequent blood tests for CA125 in the hope of catching it early," said lead author Gordon Rustin, M.D., professor of oncology at Mount Vernon Cancer Center in Hertfordshire, United Kingdom. The study was conducted by the MRC/NCRI and EORTC Gynae Cancer Intergroups. "We thought that delaying chemotherapy might make overall quality of life worse, due to the symptoms of ovarian cancer, but this was not seen in women on this trial. Since there is no benefit from early chemotherapy, patients may choose to avoid the inconvenience and anxiety associated with frequent retesting for CA125 levels as well as unnecessary early initiation of treatment for relapse."

CA125 is a marker of growth for several cancers, including ovarian cancer, and is measured by a blood test. Women who have undergone treatment for ovarian cancer may have their CA125 levels tested as often as every three months for several years after initial treatment.

In this study, investigators compared overall survival between 265 women with ovarian cancer in remission after initial chemotherapy who began second-line chemotherapy after experiencing a rise in CA125, and 264 women with rising CA125 whose treatment was delayed until symptoms of relapse appeared (such as pelvic pain or bloating).

Even though the early treatment group started second-line chemotherapy an average five months before the delayed treatment group, overall survival was the same between both groups: 41 months since completion of first-line chemotherapy.

The researchers added that this trial provides important information that will help women make informed choices about their follow-up and treatment. They can be reassured that treatment can safely be delayed until symptoms develop.