title: The feasibility of early administration of combination chemotherapy following cytoreductive surgery and second-look operation in patients with stage III ovarian carcinoma: a pilot study.
abstract: The purpose of this study is to evaluate the feasibility of early use of modified PAC-1 chemotherapy following debulking surgery and its efficacy by assessing disease status during a second-look operation. Twenty-six consecutive previously untreated patients with stage III ovarian carcinoma were evaluated in a prospective study over the 5-year period March 1981 to August 1986. Initial exploratory laparotomy was performed for staging and maximum cytoreduction. Within 24 hr postoperative modified PAC-1 (M-PAC-1) combination chemotherapy was administered and then repeated every 4 weeks for 11 months which was then followed by second-look operation. Patients were analyzed according to the following pretreatment characteristics: age, FIGO stage, histologic tumor type, extent of initial surgery, size of residual tumor, and findings during second-look. Nineteen patients were evaluable. No evidence of either microscopic or macroscopic disease was noted in 15 patients (79%), whereas the remaining 4 (21%) exhibited persistent disease. Of the remaining 7 patients not undergoing SLO, 4 completed 12 courses of chemotherapy but did not undergo surgery for medical reason (n = 2) or patient refusal (n = 2). Two more patients refused chemotherapy after 9 courses and the seventh patient expired with persistent disease after 8 courses. The early use of combination chemotherapy was well tolerated. Neurological, hematological, and renal toxicity was never severe enough to cause discontinuation of therapy.
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, State University of New York, Brooklyn 11219.
authors.forename: J R
authors.initials: JR
authors.lastname: Vardi
authors.forename: S D
authors.initials: SD
authors.lastname: Rafla
authors.forename: C
authors.initials: C
authors.lastname: Malhotra
authors.forename: G
authors.initials: G
authors.lastname: Tadros
authors.forename: T
authors.initials: T
authors.lastname: Charney
authors.forename: M
authors.initials: M
authors.lastname: Shebes
authors.forename: B J
authors.initials: BJ
authors.lastname: Berkowitz
authors.forename: J E
authors.initials: JE
authors.lastname: Kehoe
authors.forename: L M
authors.initials: LM
authors.lastname: Tancer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma / Q000628:therapy*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007813:Laparotomy; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000628:therapy*
chemical_list: D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin