[Clinical practice guidelines: Standards, Options and Recommendations for first line medical treatment of patients with ovarian neoplasms (summary report)].
BACKGROUND
The "Standards, Options and Recommendations" (SOR) project, which started in 1993, is a collaboration between the French Federation of Cancer Centers (FNCLCC), the 20 French Regional Cancer Centers, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients.


OBJECTIVE
To update clinical practice guidelines for first line medical treatment of patients with ovarian neoplasms in collaboration with the French Society for Gynaecologica Oncology.


METHODS
The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts. The CPGs are defined following the definitions of the Standards, Options and Recommendations project. Once the guideline has been developed, the document is submitted for review by independent reviewers.


RESULTS
This article is a summary version of the full document presenting the clinical practice guidelines with algorithms. After surgery, most patients with ovarian neoplasms need adjuvant medical treatment. These guidelines concern the initial medical treatment (chemotherapy, hormone treatment and immunotherapy) and potential consolidation treatment. To complete the indications, two alternative treatment strategies are taken into account: no treatment and radiotherapy. This updated version concerns the indications and the modalities of chemotherapy. The main modifications are: 1) first-line chemotherapy for ovarian neoplasm can be taxane-platinum or carboplatine alone; 2) poly-chemotherapy is no longer a standard; 3) for early stages, except for stage IA grade I non-clear-cell tumours, adjuvant chemotherapy should be preferred to no treatment; 4) chemotherapy is standard for all stage III tumours, irrespective of the surgical result; 5) for stage IA G2-3 to IIA tumours, complete surgical staging and determination of the histological grade are standards.
Lhommé
Catherine
C
Institut Gustave-Roussy, Villejuif, FRANCE.
Ray-Coquard
Isabelle
I
Guastalla
Jean-Pierre
JP
Bataillard
Anne
A
Thomas
Laurence
L
Bonnier
Pascal
P
Dargent
Daniel
D
Dohollou
Nicole
N
Ganem
Gérard
G
Lefranc
Jean-Pierre
JP
Misset
Jean-Louis
JL
Rixe
Olivier
O
Tchiknavorian
Xavier
X
Tournigand
Christophe
C
Villet
Richard
R
Bachelot
Thomas
T
Kerbrat
Pierre
P
Fervers
Béatrice
B
Basuyau
Jean-Pierre
JP
Cohen-Solal-Le Nir
Christine
C
Morice
Philippe
P
Duvillard
Pierre
P
Voog
Eric
E
D000970:Antineoplastic Agents / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001500:BCG Vaccine / Q000627:therapeutic use; D003663:Decision Trees; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D013629:Tamoxifen / Q000627:therapeutic use
D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D001500:BCG Vaccine; D013629:Tamoxifen
Recommandations pour la pratique clinique Standards, Options et Recommandations 2003 pour le traitement médical de première ligne des patientes atteintes de tumeurs épithéliales malignes de l'ovaire, mise à jour (rapport abrégé).