Chemotherapy in patients with recurrent or refractory epithelial ovarian cancer.

OBJECTIVES: To evaluate the response rates, progression-free survival, and overall survival of patients with epithelial ovarian carcinoma who were treated with chemotherapy after being resistant to or had recurrence after first-line chemotherapy. MATERIAL AND METHOD: Clinical and pathological data of all patients with epithelial ovarian carcinoma who received chemotherapy in the second-setting at the Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital from January 1994 to December 2005 were reviewed. RESULTS: During the study period, 61 ovarian carcinoma patients met the inclusion criteria. All patients had primary surgery, not responded to or had recurrence after first-line chemotherapy, and received subsequent chemotherapy. Thirty-seven cases (60. 7%) were considered as platinum-resistant and 24 cases as platinum-sensitive (39.3%). The overall response rate (RR) to subsequent chemotherapy was 23.0% (14 patients): complete response 18.0% (11 patients) and partial response 5.0% (three patients). Stable disease was achieved as the best response in 11 patients (18.0%). Thirty-six patients (59.0%) experienced disease progression. Median progression-free survival (PFS) of all 61 patients was 5.7 months (95%CI, 4.7-6.7 months) while median overall survival (OS) was 18.3 months (95%CI, 2.7-34.0 months). Some prognostic factors were studied and found that patients with platinum-sensitive had a better response rate, longer PFS and OS than those with platinum-resistant diseases. CONCLUSION: Response rate of ovarian carcinoma to subsequent chemotherapy for resistant or recurrent diseases was modest. Median PFS and OS of the patients were less than and slightly longer than a year respectively. The patients who had platinum-sensitive diseases had a better prognosis in terms of RR, PFS, and OS than those with platinum-resistant disease.

Efficacy of platinum plus cyclophosphamide in patients with epithelial ovarian cancer.

OBJECTIVES: To determine the response rate (RR), 5-year progression-free survival (PFS), and the 5-year survival rate (SVR) of epithelial ovarian cancer patients who received platinum plus cyclophosphamide as adjuvant postoperative chemotherapy. MATERIAL AND METHOD: Epithelial ovarian cancer patients who underwent tumor debulking surgery and received platinum plus cyclophosphamide as adjuvant chemotherapy at Vajira Hospital from January 1995 to December 2003 were identified. All clinical and pathological data were reviewed RESULTS: Among 114 patients included in the present study, 101 patients were evaluable for response. Overall response rate was 79.2%. The 5-year PFS and 5-year SVR were 60.3% (95% confidence interval [95% CI]; 50.5, 70.1%) and 60.7% (95% CI; 50.9, 70.5%) respectively. Subgroup analysis showed better RR, PFS, and SVR in early stage than advanced stage disease. CONCLUSION: The overall RR, 5-year PFS, and 5-year SVR of patients of the whole group were modest. These outcomes were significantly better in the early stage than the advanced stage.