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Titolo:
High-dose versus low-dose cisplatin chemotherapy plus treosulfan in epithelial ovarian carcinoma FIGO II-IV: Results of a prospective randomized trial
Autore:
Merkle, E; Ackermann, S; Beck, EP; Jager, W; Lang, N;
Indirizzi:
Stadt Frauenklin Berg, D-70190 Stuttgart, Germany Stadt Frauenklin Berg Stuttgart Germany D-70190 70190 Stuttgart, Germany Univ Erlangen Nurnberg, Geburtshilfe & Gynakol Abt, D-8520 Erlangen, Germany Univ Erlangen Nurnberg Erlangen Germany D-8520 D-8520 Erlangen, Germany
Titolo Testata:
ONKOLOGIE
fascicolo: 3, volume: 23, anno: 2000,
pagine: 232 - 238
SICI:
0378-584X(200006)23:3<232:HVLCCP>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
GYNECOLOGIC-ONCOLOGY-GROUP; CYTOREDUCTIVE SURGERY; CANCER; CYCLOPHOSPHAMIDE; CARBOPLATIN; SURVIVAL; LEUKEMIA; THERAPY; RISK;
Keywords:
cisplatin; treosulfan; dose intensity; ovarian cancer; residual tumor;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Merkle, E Stadt Frauenklin Berg, Obere Str 2, D-70190 Stuttgart, Germany Stadt Frauenklin Berg Obere Str 2 Stuttgart Germany D-70190 any
Citazione:
E. Merkle et al., "High-dose versus low-dose cisplatin chemotherapy plus treosulfan in epithelial ovarian carcinoma FIGO II-IV: Results of a prospective randomized trial", ONKOLOGIE, 23(3), 2000, pp. 232-238

Abstract

Background: Combination chemotherapies of platinum compounds with alkylating agents have been the standard treatment for patients with advanced ovarian carcinoma over the last decades. The recent development of taxans has added a group of new promising agents; however, long-term results are not yetavailable. Platin derivates have proven to be an indispensable part in combination chemotherapies for ovarian carcinoma. The dose intensity of cisplatin is, however, still a matter of debate. We report on the long-term results of a prospective randomized trial comparing two dosages of cisplatin combined with treosulfan in patients with advanced epithelial ovarian cancer. Patients and Methods: Between 1988 and 1995, 125 patients with ovarian cancer (FIGO stage II-IV) were randomized to receive 4 cycles (28-day intervals) of either cisplatin 100 mg/m(2) (high dose, HD) or 50 mg/m(2) (low dose, LD) in combination with 5 g/m(2) treosulfan after primary cytoreductive surgery. Postoperative residual tumor was absent in 39 patients (HD: 16; LD: 23), <2 cm in 61 patients (HD: 36; LD: 25) and >2 cm in 25 patients (HD: 13;LD: 12). 65 and 60 patients received HD and LD cisplatin, respectively. Second-look surgery was optional. Results: The overall response rate was 70.0% (HD: 70.9%; LD: 68.9%). Pathological complete response (CR) was seen in 45 patients (37.5%), clinical CR in 23 patients (19.2%), partial response (PR) in 16 patients (13.3%), stable disease (SD) in 2 patients, and progression of disease (PD) in 34 patients (28.3%). 5 patients were not assessable for response. Overall median survival was 25.6 (HD: 26.9, LD: 25.2) months. The overall disease-free survival for responders was 19.6 and 24.7 months (HD and LD, respectively). HD chemotherapy did not result in any significantsurvival benefit in completely resected patients: HD: 39.8 months versus LD: 49.5 months. In suboptimally debulked patients (residual tumor < 2 cm), median survival was 24.1 months (HD) versus 22.6 months (LD). In patients with residual tumors >2 cm median survival was 14.6 months (HD) versus 15.5 months (LD). Significantly less side effects were seen in the LD group: anemia (p=0.008); nephrotoxicity (p=0.014); alopecia (p=0.017). Conclusions: Our data suggest that LD cisplatin-based chemotherapy is as effective as HD chemotherapy in patients with advanced epithelial ovarian cancer, but is far less toxic.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 11:44:13