ABSTRACT
Objective: This study aims to observe the efficacy and toxicity of three-dimensional conformal radiotherapy (3DCRT) combined with weekly topotecan hydrochloride (Top-Hyd) chemotherapy on patients with platinum-resistant recurrent ovarian cancer. Methods: Medical data of 42 patients with platinum-resistant recurrent ovarian cancer between June 2008 and June 2011 were retrospectively reviewed. OAOf these 42 patients, 22 underwent 3DCRT combined with weekly Top–Hyd chemotherapy, whereas the remaining 20 underwent simple chemotherapy (SCT). Doses from 45 Gy to 65 Gy were planned to deliver fractions ranging from 1.8 Gy to 2 Gy to patient abdomen and pelvis. Top–Hyd (4 mg/m2) was aintravenously administered 1, 8, and 15 days from radiotherapy, with a cycle of 28 days. Results: By December 31, 2011, the median follow-up time for the 3DRT group was 18.5 months, whereas that for the SCT group was 10.8 months . The total response rate and the clinical beneficial rate were significantly higher in the 3DCRT group than in the SCT group (total response rate, 42.1% vs. 11.1%; clinical beneficial rate, 68.4% vs 22.2% at P0.05). Conclusion: The combined 3DCRT treatment and Top-Hyd chemotherapy results in enhanced response and tolerable toxicity compared with SCT in patients with recurrent ovarian cancer infiltrating the pelvic and retroperitoneal lymph node metastasis. So, it may be the salvage regimen for recurrent ovarian cancer and provide a new therapeutic option for the consolidation treatment of advanced ovarian carcinoma.
ABSTRACT
OBJECTIVE: Topotecan has recently been used as a second-line agent in treatment of advanced ovarian cancer. The aim of the study was to evaluate the response rate and toxicities of topotecan in patients with recurrent epithelial ovarian cancer who had been treated with platinum-containing chemotherapy. METHODS: A retrospective review of all cases of recurrent ovarian cancer treated with topotecan was done. Response was evaluated using the clinical examination, CA-125 level and radiologic reports (CT, MRI) according to RECIST criteria. The toxicities were evaluated according to GOG criteria. RESULTS: Between 1998 and 2004, 57 patients were treated with topotecan for recurrent epithelial ovarian cancer. The response rate in platinum-sensitive group was 30.8% (4/13) and the response rate in platinum-resistant group was 15.9% (7/44). The response rate in topotecan alone therapy group was 8.0% (2/25), and the response rate in topotecan plus platinum combination therapy group was 28.1% (9/32). However, topotecan plus platinum combination therapy did not demonstrate a statistically significant trend toward greater median survival than topotecan alone therapy (19.2 month versus 17.2 month, P=0.82). Neutropenia above grade 3 was noted in 70%, and anemia above grade 3 in 36.8%, and thrombocytopenia above grade 3 in 47.3%. Although most severe toxicities were due to bone marrow suppression, they were adequately managed by supportive care. CONCLUSION: The results suggest that topotecan has moderate activity in the recurrent epithelial ovarian cancer who have failed previous treatment with platinum-containing chemotherapy. The response of topotecan plus platinum combination therapy was better than topotecan alone and the potential of other combination regimen deserves further evaluations.
Subject(s)
Humans , Anemia , Bone Marrow , Drug Therapy , Neutropenia , Ovarian Neoplasms , Platinum , Retrospective Studies , Thrombocytopenia , TopotecanABSTRACT
This study was planned to evaluate the efficacy and toxicity of fosfamide/mesna plus cisplatin combined regimen in patients with recurrent and initial therapy-resistant epithelial ovarian cancer. Controversy still remains over the efficacy of cisplatin containing combined chemotherapy as the treatment of recurrent ovarian cancer and refractory to first line chemotherapy. Ifosfamide(isophosphamide) is an analog of cyclophosphamide. It has shown evidences of activity in ovarian cancer and lack of cross-resistance with cyclophosphamide. This study was undertaken for the clinical analysis and evaluation on 16 patients, who were admitted and treated with advanced or recurrent ovarian cancer at the Sooncheunhyang University Chunan Hospital from January 1994 to July 1996. The results were as follows: 1. The mean age of patients was 62 year old with range from 44 to 72. 2. The most frequent side effect was nausea and vomiting(75%), followed by leukocytopenia(68%), alopecia(44%), nephrotoxicity(37%), neurotoxicity(25%), and hepatotoxicity(12%). 3. The mean survival period was 24 months in clinical response cases ranged from 11 months to 36 months, 5 months in progressive cases ranged from 1 month to 14 months. 4. In clinical stages, stage II was 6 cases(37.5%), III was 6 cases(37.5%) and IV was 4 cases(25%). 5. Previously all patients were received debulking surgery and PAC hemotherapy. 6. Overall respons rate was 44%(7/16).