title: Sequential cisplatin-doxorubicin, early debulking surgery and intraperitoneal chemotherapy in advanced ovarian cancer. Groupe d'Etude et de Recherche sur les Cancers de l'Ovaire et Digestifs (GERCOD).
abstract: 40 patients with advanced ovarian cancer were treated with immediate debulking followed by sequential cisplatin and doxorubicin every 4 weeks, followed by second-look laparotomy (SLL). Six courses were given when residual disease (RD) was under 2 cm. When RD was over 2 cm, three courses were followed by early debulking and six more courses before SLL. Immediate debulking was optimal in 15 patients (38%) and early debulking in an additional 15 (38%). Pathological complete responses (34 evaluable cases) were observed in 14 cases (41%), partial response in 13 (38%), stable disease in 3 (9%) and progression in 5 (15%). Toxicity was mainly haematological. 11 patients with negative SLL and 15 with RD under 2 cm received intraperitoneal cisplatin 200 mg/m2 alone or with cytarabine. Median survival was 45 months: 58 months for RD under 2 cm at initial laparotomy and 31 months for RD over 2 cm. Median survival was 46 months when early debulking was successful. 5 year disease-free survival was only 16%. However, this multimodal treatment offers prolonged survival, especially in patients optimally debulked either at initial laparotomy or at early debulking surgery.
authors.affiliation: Service de Médecine Interne-Oncologie, Hôpital Saint-Antoine, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: de Gramont
authors.forename: B
authors.initials: B
authors.lastname: Demuynck
authors.forename: C
authors.initials: C
authors.lastname: Varette
authors.forename: C
authors.initials: C
authors.lastname: Louvet
authors.forename: A
authors.initials: A
authors.lastname: Pigne
authors.forename: L
authors.initials: L
authors.lastname: Marpeau
authors.forename: B
authors.initials: B
authors.lastname: Lagadec
authors.forename: J
authors.initials: J
authors.lastname: Cady
authors.forename: J Y
authors.initials: JY
authors.lastname: Couturier
authors.forename: S
authors.initials: S
authors.lastname: Delfau
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000401:mortality / Q000628:therapy*; D011379:Prognosis
chemical_list: D004317:Doxorubicin; D002945:Cisplatin