[Intermittent administration of the combination chemotherapy with cis-platin, adriamycin and cyclophosphamide (cyclic-PAC chemotherapy) for the ovarian cancers].
Despite cis-platin-based combination chemotherapy with initially high response rates in advanced ovarian cancer, the overall survival rate remains unsatisfactory. This prompted us to design a new systematic approach using a combination chemotherapy consisting of cis-platin, adriamycin and cyclophosphamide (PAC), namely cyclic-PAC chemotherapy: Three-step chemotherapies consisting of 3 courses of the PAC regimen in each step were administered for 18 months to patients with Stage Ic-IV, after cytoreductive surgery and chemotherapy. In the present study, the survival rate with the cyclic-PAC chemotherapy was compared to that with short course-PAC and FAM (5-Fu, Alkylating agent and Mitomycin C) chemotherapies. The cyclic-PAC, PAC and FAM groups included 24 cases, 31 cases and 30 cases, respectively. Treatment of Stage Ic-IV diseases by cyclic-PAC improved the outcome (66% 3-year survival rate) compared to PAC and FAM groups (PAC 35% and FAM 30% 3-year survival rates), while no difference was observed between PAC and FAM. The outcome for patients with Stage III. IV was also superior for the cyclic-PAC group compared to the PAC and FAM groups (cyclic-PAC 54%, PAC 18% and FAM 13% 3-year survival rates). Cyclic-PAC chemotherapy is capable of dramatically improving the long-term survival rate of ovarian cancer patients.
Inoue
M
M
Department of Obstetrics and Gynecology, Osaka University Medical School.
Nakanishi
K
K
Nakazawa
A
A
Ogawa
H
H
Shimizu
H
H
Saitoh
J
J
Tanaka
Y
Y
Ueda
G
G
Tanizawa
O
O
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D015996:Survival Rate
D008937:Mitomycins; D016685:Mitomycin; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D005472:Fluorouracil