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Query: UMLS:C1140680 (ovarian cancer)
 28,141 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The current status of clinical investigations of combination chemotherapies was reviewed. A randomized trial comparing low-vs high-dose cisplatin conducted in cases of testicular cancer indicated that a high-dose regime (120 mg/m2 D1) was superior to a low-dose regime (15 mg/m2 D1-5) while similar studies conducted in head & neck cancer and cervical cancer showed no significant differences. PVB or BEP in testicular cancer and CAP in ovarian cancer appear to have on established clinical role, but other combinations containing CDDP for use on various tumors are in the stage of phase II trial. Alternating non-cross combination is an attractive direction in clinical investigation but no such regimes tested in the past has shown any significant superiority over the results obtained from standard combinations.
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PMID:[Current status of combination chemotherapy]. 241 88

A 57-year-old woman was admitted to our department with headache and dizziness. About 8 months ago, she suffered from ovarian cancer disseminated in pleura and peritoneum, and was treated successfully with CAP therapy only (Cis-platin, Adriamycin and Cyclophosphamide). Intracerebellar metastasis of ovarian cancer was suspected on CT scan, and CAP therapy was employed again. She was relieved from all symptoms a week after starting the therapy. Follow up CT scan showed complete remission of the lesion. She was well for about 3 months, but was admitted again because of consciousness disturbance and headache with multiple brain metastasis. PVB therapy (Cis-platin, Vinblastine and Pepleomycin) was employed this time, and complete remission was seen again. But regrowth of intraabdominal mass lesion appeared, and she died from multiple organ failure 5 months after PVB therapy. Autopsy was not permitted, but CT scan 3 days before death revealed no intracranial lesion. Distant metastasis of ovarian cancer may become more prevalent with the development of combination chemotherapy, but no case of brain metastasis has been reported to have been treated with chemotherapy only. The authors suggest the possibility of successful treatment of such a lesion with chemotherapy including Cis-platin.
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PMID:[Brain metastasis of ovarian cancer treated by chemotherapy including cis-platin: a case report]. 247 41

Among the cooperative studies of cisplatin (CDDP) analogs in gynecologic malignancies in Japan, a phase III study of CBDCA in ovarian cancer was completed in 1988, while phase II studies of 254-S and DWA2114R are ongoing at the present time. Phase II preliminary data in ovarian cancer revealed a response rate of 25-38%, almost equi-effective and less toxic to that of CDDP. Approximately 20% response rate was achieved in CDDP refractory cases, in particular, responders were observed in mucinous and mesonephroid cases considered CDDP resistant. A phase III study of CBDCA in ovarian cancer, with a comparative study of CAP regimen suggested that CBDCA-containing regimen has an advantage of unnecessity of hydration, in spite of no significant differences response and toxicity. In the cancer of the uterine cervix, approximately 20% response rate was achieved. Of interest is that 254-S yielded a response of 60%, and the result suggested that the agent may have broad antitumor spectrums, different to that of CDDP.
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PMID:[Current status of CDDP analogs in gynecologic malignancies]. 265 28

[OBJECTIVES OF STUDY] This presentation deals with an analysis of factors to improve the survival of patients with ovarian cancer. Some 1051 patients with malignant ovarian tumors who were treated in this group, were divided into two groups for their period of treatment. Of these, 460 patients were treated 1974-1979 (retrospective group) and 591 patients treated 1979-1984, (prospective group) because chemo-immunotherapy was determined by a certain protocol in the group. [RESULTS] The survival rate of the two groups were compared, and the 5-year survival rate of prospective group was 20% higher than in the retrospective group. However, there were no significant differences of any clinical stages between retrospective group and prospective group, and the difference in 5-year survival rate was about 20% in any stages. The survival rate was also compared in accordance with histological types. The most dominant progression was seen in serous adenocarcinoma and when the cases were divided into two groups by their clinical stage; one was the early stage (Stage I) cases. The 5-year survival rate of serous ca, mucinous ca and embryonal ca (Higuchi, Kato) made remarkable progress in recent several years, but, mesonephroid ca made little progress. The other was the late stage (stage II, III, IV) cases, patients with mucinous ca when she had had surgery recurrently on relapse, resulting in prolonged survival period. As to the comparison of age groups, younger patients less than 40 years old showed a progression in their survival period, whereas patients in their sixties had no such progression. In order to evaluate the effect of treatment with due comparable counterpart of ovarian carcinoma, cases were quantified with 3 years survival prediction score which was calculated retrospectively by multivariate statistical analysis. The first evaluation was done with an MFC combination chemotherapy and a CAP combination. The results indicated that a CAP combination had improved the survival rate of ovarian cancer, and statistically significant differences were proved. Z value was 2.24 and P value was less than 5%. The second evaluation was done on the significance of second look operation. The prediction score of patients who underwent second look operation and matched pair control of prediction score without reoperation, were compared. The results indicated that second look operation improved the survival rate of ovarian cancer with statistically significant differences. Z value was 2.37 and P value was less than 5%. [CONCLUSION] According to the present study, the treatment of malignant ovarian tumors showed an improved survival rate of about 20%, regardless of the cl
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PMID:[An analysis of factors influential in improving the survival rate of patients with ovarian cancer]. 273 4

To reassess the role off SLO in the ovarian cancer, 96 patients who underwent second laparotomy from 1968 to 1987 in our department were studied. 59 out of 96 (60.5%) were completed primary surgery while rest of them (39.5%) were incompletely resected. SLO was carried out in 34 patients of former group (57.6%) and in 9 patients in later group (24.3%). Recurrence was found in 3 patients of complete primary surgery + SLO (group A) whereas 5 patients of incomplete primary surgery + SLO (group C). Recurrence rate was significantly lower in group A. There was no relationship between the site of recurrence and survival time. Until we obtain a good tool to detect recurrence site, SLO has an important role for the management of patients. Combination of radical debulking surgery and CAP regimen with 70 mg/m2 of CDDP at least for 2 years with SLO is considered to be important to improve prognosis and quality of life of ovarian cancer patients.
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PMID:[Reassessment of second-look operations (SLO) in the treatment of ovarian cancer]. 273 43

Several general conclusions are beginning to emerge from the series of prospective trials in the treatment of ovarian cancer. Combination chemotherapy continues to demonstrate higher overall response rates and higher complete remission rates than single alkylating agents, although in some studies survival is not significantly different. Nevertheless, long-term disease-free survivals, although uncommon, are more frequent with combinations, particularly when the dose intensity of the combination is adequate. Although CAP is the most commonly used combination, evidence continues to suggest that cyclophosphamide/cisplatin alone may be equivalent. Several studies have incorporated alkylating agent maintenance into their clinical trials and each reports acute leukemic complications. In light of the absence of a major contribution for this approach, alkylating agent maintenance in ovarian cancer should not be encouraged. Several studies this year emphasize the discouraging results associated with the use of total abdominal radiation therapy post-induction chemotherapy even with patients with minimal or no residual disease. In light of the publications this year and of previously published studies, this approach, although based on sound rationale, appears to be of limited benefit. Salvage chemotherapy, in general, has been unsatisfactory. The 2 interesting reports this year were the activity of low-dose mitomycin C and the potential utility of VP-16/cisplatin combinations in a salvage setting. In cervix carcinoma, trials have documented significant activity for the new drugs, carboplatin (28% response) and ifosfamide (30%), but each has significant side effects. Whether these will prove more active than cisplatin or whether they may be used in combination is unresolved. The continued investigation into the use of radiation sensitizers in cervical carcinoma is of interest and several studies using weekly low-dose cisplatin have established the feasibility of this approach, although long-term survival benefits have not yet been documented. In endometrial carcinoma, epidemiologic studies continue to define the role of postmenopausal estrogens in endometrial carcinoma risk. This year a Swedish study documents a smaller overall risk from estrogen treatment, perhaps related to a substantially lower use of conjugated estrogens in that country. Combination chemotherapy continues to show some activity, although the contribution of combinations in excess of the single agent activity of doxorubicin is still poorly documented. One study does demonstrate significant activity for the commonly used CAP regimen with an overall response rate of 56% and 28% complete remissions.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Gynecologic malignancies. 285 38

A phase III study of carboplatin vs cisplatin in CAP regimen for ovarian cancer was conducted by a cooperative study group consisting of 22 institutions nationwide. The response rate for 23 cases allocated to carboplatin regimen group was 34.8% and 42.1% for 19 cases allocated to cisplatin regimen group. No significant difference was observed between these two regimens in response rates, and no significant differences were noted between the two regimens in each of the clinical toxicities and abnormalities in laboratory findings. Since the carboplatin regimen group did not require hydration, or the use diuretics or antiemetics, these results suggested that carboplatin is more useful in the treatment of ovarian cancer than cisplatin.
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PMID:[Phase III study of carboplatin in ovarian cancer]. 304 76

Fourteen evaluable patients with gynecologic adenocarcinoma (7 ovarian, 4 endometrial, 2 peritoneal and one breast cancer) were treated with ifosfamide (1 g/m2 X 5 days), adriamycin (50 mg/m2) and cisplatin (50 mg/m2) combined chemotherapy (IAP). All the patients had measurable disease, and three were refractory cases who had received prior chemotherapy including two CAP (cyclophosphamide, adriamycin and cisplatin). To avoid hemorrhagic cystitis induced by ifosfamide, uroprotective mesna (400 mg/body X 3) was used following ifosfamide infusion. The 5-day schedule of IAP treatment brought a 100% response rate in these patients. Complete responses were observed in 3 patients and lasted 6, 10 and 12 months. Partial responses were achieved in 11 patients including two with CAP refractory ovarian cancer, although the remission in previously treated patients was of short duration. Hematologic side effects of the IAP regimen were severe, showing grade 4 leucopenia in 85.7% of the patients, and it required maximal anti-infection treatments. Mesna resulted in microhematuria in only one patient. Despite high age of the patients (mean age: 60.1 years) in this study, CNS (central nervous system) toxicities associated with ifosfamide and mesna treatment were minimal. The results suggested that the IAP combination therapy was effective and acceptable in the control of gynecological adenocarcinomas.
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PMID:Treatment of gynecological adenocarcinomas with a combination of ifosfamide, adriamycin and cisplatin. 313 35

The therapeutic efficacy of the combination of cyclophosphamide + epirubicin + cisplatin was evaluated in 107 previously treated or untreated patients with advanced ovarian cancer. The overall response rate was 58.8%, complete remission 36.4% (mean duration-7.62 months) and partial remission 22.4% (mean duration-6.74 months). The response was rated in function of age, menopausal status, performance status and previous therapy. Toxicity (in case of 109 patients) was evaluated according to the WHO recommendation. The similar therapeutic effectiveness and less toxicity of the above drug combination compared to CAP regimen is demonstrated.
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PMID:Activity of epirubicin in combination chemotherapy of advanced ovarian cancer. Results of the South-East European Oncology Group (SEEOG) Study. 355 83

The combinations of triethylenethiophosphoramide and methotrexate (TM) and cyclophosphamide, Adriamycin (doxorubicin), and 5-fluorouracil (CAF) were compared, both as sequential and fixed rotational treatments for advanced ovarian cancer, with L-phenylalanine mustard (L-PAM). Treatment with CAF produced a higher response rate (25% complete responses plus 31% partial responses) than treatment with L-PAM (15% complete responses plus 18% partial responses). A fixed rotation of TM and CAF resulted in longer survival (median of 15 months and 75th percentile of 27 months) than sequential treatment with TM initially, followed by CAF upon failure (median of 12 months and 75th percentile of 22 months). The fixed rotation of TM and CAF also increased progression-free survival (median of 12 months and 75th percentile of 24 months) over that achieved by initial treatment with TM (median of 6 months and 75th percentile of 15 months) or L-PAM (median of 9 months and 75th percentile of 21 months). Most patients (96%) on the fixed rotation were treated with both TM and CAF. Fewer patients (62%) on the sequential schedule with TM actually received both combination regimens, and even fewer patients (37%) beginning on CAF ever crossed over to TM. Patient age of 50 years or younger was a favorable prognostic factor for response, survival, and time to first treatment failure (progression-free survival). Disease Stage IIIA or IIIB, surgery including a bilateral salpingo-oophorectomy plus hysterectomy, and treatment within 6 months of initial diagnosis were favorable predictors for both survival and time to first treatment failure. Ambulatory performance status and well-differentiated disease were favorable prognostic factors for survival. Patients with unevaluable disease failed later than those with evaluable disease who, in turn, failed later than patients with measurable disease.
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PMID:A randomized comparison of cyclophosphamide, Adriamycin, and 5-fluorouracil with triethylenethiophosphoramide and methotrexate, both as sequential and as fixed rotational treatment in patients with advanced ovarian cancer. 391 52


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