Neoadjuvant chemotherapy with six cycles of carboplatin and paclitaxel in advanced ovarian cancer patients unsuitable for primary surgery: Safety and effectiveness.

Autor: da Costa Miranda V; Instituto do Cancer do Estado de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo CEP: 01246-000, Brazil.. Electronic address: vamedabc@yahoo.com.br., de Souza Fêde ÂB; Instituto do Cancer do Estado de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo CEP: 01246-000, Brazil., Dos Anjos CH; Instituto do Cancer do Estado de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo CEP: 01246-000, Brazil., da Silva JR; Instituto do Cancer do Estado de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo CEP: 01246-000, Brazil., Sanchez FB; Instituto do Cancer do Estado de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo CEP: 01246-000, Brazil., da Silva Bessa LR; Instituto do Cancer do Estado de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo CEP: 01246-000, Brazil., de Paula Carvalho J; Instituto do Cancer do Estado de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo CEP: 01246-000, Brazil., Filho EA; Instituto do Cancer do Estado de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo CEP: 01246-000, Brazil., de Freitas D; Instituto do Cancer do Estado de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo CEP: 01246-000, Brazil., Del Pilar Estevez Diz M; Instituto do Cancer do Estado de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo CEP: 01246-000, Brazil.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2014 Feb; Vol. 132 (2), pp. 287-91. Date of Electronic Publication: 2013 Dec 09.
DOI: 10.1016/j.ygyno.2013.12.002
Abstrakt: Objective: Three cycles of neoadjuvant chemotherapy (NACT) followed by interval debulking (ID) surgery is an alternative for patients with advanced ovarian cancer unresectable disease. This study aimed to determine the efficacy and safety of six cycles of NACT followed by cytoreduction.
Methods: Retrospective analysis of all patients with advanced epithelial ovarian cancer, tubal carcinoma, or primary peritoneal carcinoma treated with platinum based NACT between January 2008 and February 2012.
Results: Eighty-two patients underwent NACT; 78% and 18.2% had extensive stage IIIC or IV disease at diagnosis, respectively. Their median age was 60 years (41-82). On histology, serous adenocarcinoma was found in 90.2%. Patients did not receive chemotherapy after debulking surgery. 35.4% suffered grade 3/4 toxicity; the most commonly observed toxicities were hematologic and nausea. After NACT, 23.1% experienced clinical complete response, 57.4% partial response, and 12.1% disease progression. Complete resection of all macroscopic and microscopic disease (R0) was performed in 63.7%. Surgical complications were uncommon; however, four (6.2%) patients needed a second procedure due to operative complications and 18 (27.3%) needed blood transfusion after debulking. Over a median follow-up period of 19.2 months, median overall survival and chemotherapy-free interval were 37.5 months (confidence interval not reached) and 16 months, respectively.
Conclusion: Six cycles of neoadjuvant carboplatin and paclitaxel was safe and effective and did not increase perioperative or postoperative complications in patients with stage IIIC/IV disease who were unsuitable for optimal PDS. The overall survival of this cohort was higher than that of those treated with ID surgery.
(Copyright © 2013 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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