title: Treatment of advanced ovarian cancer with cisplatin, adriamycin and cyclophosphamide (PAC).
abstract: Forty two ovarian cancer patients with residual disease after the first laparotomy were treated with the combination of cisplatin (80 mg/m2 day 1), adriamycin (50 mg/m2 i.v. day 2) and cyclophosphamide (500 mg/m2 i.v. day 2) (PAC). Forty women were considered evaluable for analysis, with an overall response rate (partial, plus complete responses) of 62.5%. Twelve patients (30%) obtained a complete response (histologically confirmed after second look surgery in 6 cases, surgical complete response, residual tumor completely resected in the second look-in 5 cases and maintained complete clinical remission without second look confirmation in 1 case). Main side effects were nausea and vomiting (90%), leukopenia (70%), mucositis (45%), and anemia (37%). Seventeen percent of the patients were free of disease at 60 months, after a median follow-up of 48 months. The prognostic factors that showed significant influence on survival were the Karnofski index (90-100 vs 80 or less), stage of the disease (II + III vs IV) and the volume of residual tumor after the first surgical procedure (less than or equal to 2 cms vs greater than 2 cms). Patients who achieved a complete remission have not reached the median 5 years survival, which was 10 months for the remaining patients. These results confirm the activity of PAC in ovarian cancer, mainly in those patients with residual tumor of less than 2 cms and good performance status.
authors.affiliation: Hospital Universitario San Carlos, School of Medicine, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Diaz-Rubio
authors.forename: M
authors.initials: M
authors.lastname: Escudero
authors.forename: M
authors.initials: M
authors.lastname: Martin-Jimenez
authors.forename: J A
authors.initials: JA
authors.lastname: Vidart
authors.forename: J L
authors.initials: JL
authors.lastname: Gonzalez-Larriba
authors.forename: M A
authors.initials: MA
authors.lastname: Herraiz
authors.forename: J M
authors.initials: JM
authors.lastname: Lopez Vega
authors.forename: F
authors.initials: F
authors.lastname: Bullon
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin