Modares Gilani M, Behtash N, Karimi Zarchi M, Samizadeh Z, Ghaemmaghami F, Mousavi A,
Volume 66, Issue 7 (10-2008)
Abstract
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Background: Ovarian
cancer is the leading cause of death among all gynecologic cancers in developed
countries. The standard treatment for advanced ovarian cancer consists of
cytoreductive surgery associated with a platinum/paclitaxel-based chemotherapy.
Over than 50% of patients with advanced ovarian cancer will develop
recurrent disease. For those patients who have recurrence of disease at least six
months after initial therapy, the paclitaxel- platinum combination has been
shown to be a superior treatment to platinum monotherapy. However, many
patients develop clinically relevant neurotoxicity, frequently resulting in
treatment discontinuation. The efficacy and safety of an alternative regimen
that dose not show significant neurotoxicity were evaluated by comparing
gemcitabin- carboplatin with carboplatin in platinum sensitive recurrent
ovarian cancer patients in a Gynecologic Cancer InterGroup trial in Canada and
European Organization for research and treatment of Cancer Gynecological Cancer
Group. But this study was not done in Iran.
Methods: We performed a study with escalating doses of
gemcitabin combined with carboplatin in 21 patients. All patients who were treated in Vali-Asr
hospital between 2003- 2005 evaluated. Gemcitabin with dose of 800mg/m2 was given on days 1, 8 and 15 followed by one week rest period for a 28 day cycle.
Combine with carboplatin with AUC 4 given on day 2. All patients with surgically resected,
histologically confirmed epithelial ovarian cancer and who had failed first-
line platinum chemotherapy were allocated to this study.
Results: Median age was 49 years (range 23-78 years). Median follow-up was six months (range 4-22). Total of 87 cycles of
chemotherapy were administered with median number of four (range 2-6 cycles).
Thrombocytopenia (grade I) and leucopenia (grade I) were seen in 4.75% and 9.52% of patients.
Conclusion: Gemcitabin and carboplatin Combination was tolerated
in patients with recurrence of ovarian cancer.
Azamsadat Mousavi , Mojgan Karimi-Zarchi , Nadereh Behtash , Mahnaz Mokhtari-Gorgani , Nili Mehrdad , Mitra Rouhi , Seyedhossein Hekmatimoghaddam,
Volume 72, Issue 4 (7-2014)
Abstract
Background: The aim of this study was to assess the role of consolidative intraperito-neal chemotherapy with carboplatin in decreasing relapse and increasing survival in advanced epithelial ovarian cancers, as well as evaluation of its toxicity.
Methods: In this clinical trial 30 patients with epithelial ovarian cancer in stages II-IV who had complete surgery (optimal debulking surgery) received six standard cycles of intravenous carboplatin and paclitaxel. They were enrolled through non-random se-quential selection. The control patients were similar to case group in stage (II-IV) and pathology (epithelial ovarian cancer). The control group was evaluated retrospectively through hospital files. This clinical trial performed in Gynecology Oncology department in Tehran Valiasr University Hospital, during 2005-2010. They including 18 cases as the intervention group receiving intraperitoneal chemotherapy and 12 patients as the control group with only retrospective follow-up. The cases received 3 cycles of 400 mg/m2 intraperitoneal carboplatin every 21 days following intravenous chemotherapy. Relapse of disease was diagnosed as increasing or even doubling CA125 serum titer during one month, or any CA125 above 100 IU, or an abdominal or pelvic mass in ul-trasound or physical exam. Mean survival of two and five years, progression-free inter-val (PFI), overall survival (OS), relapse, demographic parameters, drug toxicities, path-ologic types of cancers in two groups were coded and compared using SPSS 14. Any P<0.05 was considered as a significant difference.
Results: The mean ages of cases and controls were 52.4±8.6 and 55.1±11.5 years. The mean duration of relapse-free survival was 13±8.6 months for the cases and 9.5±4.3 months for the control patients (not statistically different, P>0.05). The mean overall survival for cases and controls were 39±16.5 and 30.8±16.2 months, respectively (no significant difference, P>0.05). The frequency of drug toxicities in the cases was 5.6%, and consisted of mild-to-moderate abdominal pain, nausea and vomiting.
Conclusion: It seems that consolidation therapy with intraperitoneal carboplatin may not increase overall survival, reduce relapse rate or decrease mortality, though it does not induce considerable side effects. Since the mean survival in the intervention group was nine months more than controls, this difference may be clinically significant.
