[Comparison of preoperative and postoperative chemotherapy in the treatment of advanced ovarian cancer].
Temporary blockage of uterine and ovarian vessels with forceps led to an approximately two-fold increase in the transfer of LMOX and Carboplatin to uterine muscle, ovarian tissue and pelvic lymph-nodes after the release of forceps. This result suggests the importance of preserving these main vessels for the effective transfer of chemotherapeutic agents to target tissues. Ten cases in stage III or IV underwent cytoreductive surgery followed by three courses of CDDP, ADM, CPA chemotherapy and SLO (postop. group). A further 27 cases were given diagnostic laparotomy followed by the same chemotherapy and SLO (preop. group). Examination of both groups revealed the following: The efficacy rate of the CAP regimen was 77.8% in the preop. group and 50.0% in the postop. group; the surgical extirpation rate exceeding 90% at SLO was 76.1% and 50.0% in the preop. and postop. groups respectively. The survival period was longer in the preop. group, ie., two years in 69% versus 40% and three years 43% v 20% of the preop. and postop. groups, respectively. Preoperative (Neo-adjuvant) chemotherapy followed by aggressive surgery was concluded to be preferable to carrying out enforced reduction surgery first on such advanced cases where the mass of the residual disease cannot be left untouched is unavoidable.
Hirabayashi
K
K
Department of Obstetrics and Gynecology, Fukuyama National Hospital, Hiroshima.
Okada
E
E
Nakazuma
Y
Y
Akamatsu
Y
Y
D000970:Antineoplastic Agents / Q000493:pharmacokinetics; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003536:Cystadenocarcinoma / Q000188:drug therapy / Q000378:metabolism / Q000601:surgery; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000378:metabolism; D009070:Moxalactam / Q000493:pharmacokinetics; D009944:Organoplatinum Compounds / Q000493:pharmacokinetics; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D010053:Ovary / Q000098:blood supply / Q000378:metabolism; D012074:Remission Induction; D014018:Tissue Distribution; D014599:Uterus / Q000098:blood supply / Q000378:metabolism
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D004317:Doxorubicin; D003520:Cyclophosphamide; D016190:Carboplatin; D002945:Cisplatin; D009070:Moxalactam