title: Five-year results of cyclic semi-high dose neoadjuvant chemotherapy supported by autologous peripheral blood stem-cell transplantation in patients with advanced ovarian cancer.
abstract: BACKGROUND
  To achieve anti-ovarian tumor responses similar to those obtained with high-dose chemotherapy but with milder side effects, we developed a treatment protocol in which semi-high dose multi-cycle neoadjuvant chemotherapy was supported by autologous peripheral blood stem-cell transplantation (auto-PBSCT).
  
  
  METHODS
  Seventeen patients with advanced ovarian cancer were enrolled in this study. Two cycles of semi-high dose neoadjuvant chemotherapy, using carboplatin (AUC, 8.75; average dose, 621 mg/m(2)) and etoposide (average dose, 960 mg/m(2)) were supported by auto-PBSCT and followed by cytoreductive surgery and further chemotherapy. Each patient was followed for at least 5 years.
  
  
  RESULTS
  This treatment schedule achieved an overall response rate of 70.6% in 17 patients with stage III or stage IV ovarian cancer. The 5-year disease-free survival rate was 52.9% (95% confidence interval, 29.2%-76.6%) and the median survival time was 63 months (95% confidence interval, 16-79 months). Thus, we obtained superior treatment outcomes in these 17 patients in comparison with published conventional protocols.
  
  
  CONCLUSIONS
  Cyclic semi-high dose neoadjuvant chemotherapy supported by auto-PBSCT may be tolerable and favorable for patients with advanced ovarian cancer. To achieve anti-ovarian tumor responses similar to those obtained with high-dose chemotherapy but with milder side effects, we developed a treatment protocol in which semi-high dose multi-cycle neoadjuvant chemotherapy was supported by autologous peripheral blood stem-cell transplantation (auto-PBSCT).
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical School, Saitama, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ikeba
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Okubo
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeda
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kinoshita
authors.forename: Hiroo
authors.initials: H
authors.lastname: Maeda
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005047:Etoposide / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D010865:Pilot Projects; D016019:Survival Analysis; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D016190:Carboplatin