The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer , neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality .
PURPOSE To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer .
Phase III trial of standard-dose intravenous cisplatin plus paclitaxel versus moderately high-dose carboplatin followed by intravenous paclitaxel and intraperitoneal cisplatin in small-volume stage III ovarian carcinoma: an intergroup study of the Gynecologic Oncology Group, Southwestern Oncology Gr
PURPOSE To compare the progression-free and overall survival in small-volume residual ovarian cancer after treatment with intravenous ( IV ) cisplatin and paclitaxel or an experimental regimen of IV carboplatin followed by IV paclitaxel and intraperitoneal cisplatin . PATIENTS AND METHODS Patients were r and omized to receive either IV paclitaxel 135 mg/m(2 ) over 24 hours followed by IV cisplatin 75 mg/m(2 ) every 3 weeks for six courses or IV carboplatin ( area under curve 9 ) every 28 days for two courses , then IV paclitaxel 135 mg/m(2 ) over 24 hours followed by intraperitoneal ( IP ) cisplatin 100 mg/m(2 ) every 3 weeks for six courses . RESULTS Of the 523 patients who entered this trial , 462 were determined to be assessable , with prognostic factors well balanced between the treatments . Neutropenia , thrombocytopenia , and gastrointestinal and metabolic toxicities were greater in the experimental arm . As a result , 18 % of the patients received < or = two courses of IP therapy . Progression-free survival was superior for patients r and omized to the experimental treatment arm ( median , 28 v 22 months ; relative risk , 0.78 ; log-rank P = .01 , one-tail ) . There was a borderline improvement in overall survival associated with this regimen ( median , 63 v 52 months ; relative risk , 0.81 ; P = .05 , one-tail ) . CONCLUSION An experimental regimen including moderately high-dose IV carboplatin followed by IP paclitaxel and IV cisplatin yielded a significant improvement in progression-free survival when compared with a st and ard regimen of IV cisplatin and paclitaxel . Because the improvement in overall survival was of borderline statistical significance and toxicity was greater , the experimental arm is not recommended for routine use . However , the results provide direction for further clinical investigation in small-volume ovarian cancer
The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer , neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality .
PURPOSE To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer .