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Titolo:
A comparative study of intraperitoneal carboplatin versus intravenous carboplatin with intravenous cyclophosphamide in both arms as initial chemotherapy for stage III ovarian cancer
Autore:
Polyzos, A; Tsavaris, N; Kosmas, C; Giannikos, L; Katsikas, M; Kalahanis, N; Karatzas, G; Christodoulou, K; Giannakopoulos, K; Stamatiadis, D; Katsilambros, N;
Indirizzi:
Univreecens, Sch Med, Laikon Hosp, Dept Propedeut Med 1, GR-11527 Athens, G Univ Athens Athens Greece GR-11527 t Propedeut Med 1, GR-11527 Athens, G Univ Athens, Sch Med, Laikon Hosp, Med Oncol Unit, GR-11527 Athens, GreeceUniv Athens Athens Greece GR-11527 d Oncol Unit, GR-11527 Athens, Greece Univ Athens, Sch Med, Laikon Hosp, Dept Gynecol, GR-11527 Athens, Greece Univ Athens Athens Greece GR-11527 Dept Gynecol, GR-11527 Athens, Greece Univ Athens, Sch Med, Laikon Hosp, Dept Gen Surg, GR-11527 Athens, Greece Univ Athens Athens Greece GR-11527 ept Gen Surg, GR-11527 Athens, Greece
Titolo Testata:
ONCOLOGY
fascicolo: 4, volume: 56, anno: 1999,
pagine: 291 - 296
SICI:
0030-2414(1999)56:4<291:ACSOIC>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
LONG-TERM SURVIVAL; SALVAGE THERAPY; CISPLATIN; CARCINOMA; ETOPOSIDE; CYTARABINE; TUMORS; TRIAL;
Keywords:
ovarian cancer; intraperitoneal chemotherapy; carboplatin; cyclophosphamide;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Polyzos, A Univreecens, Sch Med, Laikon Hosp, Dept Propedeut Med 1, GR-11527 Athens, G Univ Athens Athens Greece GR-11527 Med 1, GR-11527 Athens, G
Citazione:
A. Polyzos et al., "A comparative study of intraperitoneal carboplatin versus intravenous carboplatin with intravenous cyclophosphamide in both arms as initial chemotherapy for stage III ovarian cancer", ONCOL-BASEL, 56(4), 1999, pp. 291-296

Abstract

Cisplatin (C) or carboplatin (CBP) plus cyclophosphamide (CTX) was until recently considered standard chemotherapy for advanced ovarian cancer (OC). Attempts to maximize platinum and its analog activity against OC include its administration directly into the peritoneal cavity. In the past we have shown that intraperitoneal (IP) CBP administration is a safe and effective treatment for OC [Polyzos et al: Proc Am Assoc Cancer Res 1990;31: 1120]. Inthe present study we aimed to compare the effectiveness and toxicity of CBP administration either intravenously (IV) or IP plus CTX IV. Since 1990, 90 evaluable patients with stage III OC were prospectively randomized to receive CBP 350 mg/m(2) IV or IP plus CTX 600 mg/m(2) IV (in both groups) every 3-4 weeks for six courses. The randomization incorporated stratification according to performance status and the amount of residual tumor (maximum diameter less than or equal to 2 or >2 cm). Clinical assessment was performed with abdominal CT and serum CA-125. Responses were observed in 33/46 = 72% (95/CI 56.5-84.0) of the IV group and in 33/44 = 75% (95/CI 59.7-86.8) ofthe IP group with 48 and 45% clinical complete responses, respectively. Times to progression were 19 months (8-62+) for the IV group and 18 (6-72+) for the IP group. Median survivals were: 25 months (6-80+) and 26 months (6-72+), respectively. Significantly more patients in the IV group than in theIP group had grade 3 or higher leukopenia (p < 0.01) and grade 3 thrombocytopenia (p < 0.09). Morbidity due to infectious complications in the IP group was minimal. It seems that IP CBP is equally effective to IV administration in terms of response and survival with less myelotoxicity. The favorable results on survival demonstrated in studies with IP C administration in patients with small volume disease [Alberts et al: N Engl J Med 1996;335:1950-1965] could not be repeated in the present study applying CBP in patientswith variable tumor size and a relatively small number of patients. The likelihood that patients with large volume disease would benefit from a regional approach compared to systemic administration is small and this explainsthe inability to detect a difference between the two arms.

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Documento generato il 20/09/20 alle ore 07:44:04