Long-term follow-up of patients with advanced ovarian carcinoma treated with chemotherapy.
BACKGROUND
The evolution of the management of advanced ovarian carcinoma over the last fifteen years has resulted from a number of well-designed randomized trials involving large numbers of patients.


METHODS
A critical review of long-term follow-up of patients entered onto eleven major randomized trials of advanced ovarian carcinoma has been performed.


RESULTS
In the pre-platinum era no long-term survival benefit was obtained with combination compared with single agent chemotherapy. When adding cisplatin to front-line therapy at least a short-term gain in terms of superior response rate and progression-free intervals is obtained compared with non-cisplatin combination chemotherapy. Survival data are more difficult to assess due to the use of cisplatin-containing salvage therapy. Cisplatin-based combination therapy also offers enhanced patient benefit when compared with cisplatin alone. A slight advantage favouring anthracycline-containing therapy is observed, whereas no advantage is obtained with alternating cisplatin and non-cisplatin regimens or by adding BCG.


CONCLUSIONS
Platinum-based combination chemotherapy is clearly associated with improved response rates and progression-free survival and, at least in some studies, better overall survival. At least six cycles of therapy should be given. Such approaches should yield long-term survival rates of 10% or better for patients with large-volume disease and 20% or better for small-volume disease.
Thigpen
J T
JT
Department of Medicine, University of Mississippi School of Medicine, Jackson.
Bertelsen
K
K
Eisenhauer
E A
EA
Hacker
N F
NF
Lund
B
B
Sessa
C
C
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors
D000970:Antineoplastic Agents