[Impact of dose delivery of postoperative first-line chemotherapy on prognosis of stage III C epithelial ovarian carcinoma].
OBJECTIVE
Chemotherapy, which includes selecting appropriate drugs and suitable dose, is necessary to advanced ovarian carcinoma. Whether dose delivery affects prognosis of ovarian cancer is controversial. This study was to investigate the impact of dose delivery of postoperative first-line chemotherapy on prognosis of stage III C epithelial ovarian carcinoma.


METHODS
Clinical data of 47 stage III C epithelial ovarian carcinoma patients, treated with cisplatin-based adjuvant first-line chemotherapy, were retrospectively analyzed. The relative cumulative dose (CD) and dose intensity (DI) were calculated for each drug and for all drugs combined (namely overall CD and overall DI). The impact of dose delivery on progression-free survival (PFS) and overall survival (OS) was analyzed.


RESULTS
Median overall CD was 0.76, and median overall DI was 0.53; the median CD of cisplatin was 0.78, and the median DI of cisplatin was 0.57; the median CD of paclitaxel was 0.81, and the median DI of paclitaxel was 0.51. Dose delivery had no impact on PFS and OS of the patients. However, in non-paclitaxel chemotherapy subgroup, the higher overall CD, or CD for cisplatin, or DI for cisplatin, the longer PFS (P=0.01, P=0.03, P=0.01) and OS (P=0.01, P=0.04, P=0.01); in paclitaxel chemotherapy subgroup, dose delivery had no impact on PFS and OS. In suboptimal surgery subgroup (residual disease of > 2 cm), the higher DI for cisplatin, the longer PFS; the higher overall CD, or DI for cisplatin, the longer OS. In optimal surgery subgroup (residual disease of < or =2 cm), dose delivery had no impact on PFS and OS. Residual disease was the only independent prognostic factor of epithelial ovarian carcinoma.


CONCLUSIONS
The dose delivery below standard level may influence survival of the patients with residual disease of > 2 cm or treated by non-paclitaxel chemotherapy. The diameter of residual disease is the independent prognostic factor of epithelial ovarian carcinoma.
Zhao
Xiao-Dong
XD
Department of Obstetrics and Gynecology, Beijing Hospital, Beijing, P. R. China. sparkling8027@yahoo.com
Zhang
Qiao
Q
Zhang
Yi
Y
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D017239:Paclitaxel / Q000008:administration & dosage; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D017239:Paclitaxel; D002945:Cisplatin