title: Carboplatin with cyclophosphamide in patients with advanced ovarian cancer: an efficacy and quality-adjusted survival analysis.
abstract: The efficacy and toxicity of a combination of carboplatin and cyclophosphamide (CC) were studied in a group of 76 patients with advanced ovarian cancer. Progression-free (PFS) and overall survival were compared with a historical group of 65 patients treated with CAP-5 (cyclophosphamide, adriamycin, cisplatin). Subjective toxicity was compared by the measurement of TWiST, the Time Without Symptoms of Disease or Treatment. Of 75 evaluable patients treated with CC, 18 (24%) had a pathologically complete remission (pCR), and 31 (41%) a partial remission (PR). CC led to leukopenia grade III in 38% and grade IV in 3% of 421 treatment cycles. Thrombocytopenia grade III was seen after 7% and grade IV after 2% of cycles. Treatment delay occurred in 11.5% and dose reduction in 21% of cycles. Nephro- or neurotoxicity did not occur. After a median follow-up of 18 months, the median PFS was 24 months and the overall survival was 25 months. Median duration of TWiST was 22 versus 10 months after CAP-5 (P < 0.01). Compared with historical controls, treatment with CC is equivalent to CAP-5. It is free of nephro- and neurotoxicity, but is more myelosuppressive. Quality of life, measured by TWiST, is significantly better during CC. As a consequence of its equivalent efficacy, but lower subjective toxicity, carboplatin should replace cisplatin in treating patients with advanced ovarian cancer.
authors.affiliation: Departments of Medical Oncology and Gynecologic Oncology, University of Groningen, Ny Smellinghe Hospital Drachten, Scheper Hospital Emmen, The Netherlands.
authors.forename: P.H.B.
authors.initials: PH
authors.lastname: Willemse
authors.forename: E.G.E.
authors.initials: EG
authors.lastname: De Vries
authors.forename: M.
authors.initials: M
authors.lastname: Kloppenburg
authors.forename: D.L.
authors.initials: DL
authors.lastname: Fontein
authors.forename: J.G.
authors.initials: JG
authors.lastname: Aalders
authors.forename: H.
authors.initials: H
authors.lastname: Boonstra
authors.forename: N.H.
authors.initials: NH
authors.lastname: Mulder
authors.forename: D.Th.
authors.initials: DT
authors.lastname: Sleijfer