Progression-free survival and overall survival of patients with clear cell carcinoma of the ovary treated with paclitaxel-carboplatin or irinotecan-cisplatin: retrospective analysis.
BACKGROUND
Irinotecan hydrochloride, a topoisomerase I inhibitor, has been preliminarily recognized as an effective agent against clear cell carcinoma of the ovary (CCC), but there are few clinical data. Our aim was to compare progression-free survival (PFS) between patients treated with irinotecan hydrochloride and cisplatin (CPT-P) and those with treated with paclitaxel and carboplatin (TC).


METHODS
One hundred and seventeen patients at International Federation of Gynecology and Obstetrics (FIGO) stages Ic (ascites/malignant washing) - IV were identified by scanning the medical records of ten Japanese hospitals. After complete surgical staging procedures including lymphadenectomy, 35 patients received CPT-P and 82 patients received TC. The PFS and overall survival of the two groups were compared using the Kaplan-Meier method.


RESULTS
There was no significant difference in median age, performance status, FIGO stage, rate of optimal cytoreduction, or follow-up period between the CPT-P and TC groups. Two-year and 5-year PFS was 48% and 40%, respectively, in the TC group and 55% and 55%, respectively, in the CPT-P group (P = 0.31). Multiple regression analysis revealed that only residual tumor was an independent prognostic factor for PFS (P < 0.01).


CONCLUSIONS
CPT-P showed a potential therapeutic effect, at least no less than that of TC therapy. Although there was no significant survival benefit in the present retrospective analysis, we recommend that the CPT-P regimen be evaluated in a larger, prospective, clinical trial.
Takano
Masashi
M
Department of Obstetrics and Gynecology, National Defense Medical College, Namiki 3-2, Tokorozawa, Saitama, 359-8513, Japan. mastkn@ndmc.ac.jp
Sugiyama
Toru
T
Yaegashi
Nobuo
N
Suzuki
Mitsuaki
M
Tsuda
Hiroshi
H
Sagae
Satoru
S
Udagawa
Yasuhiro
Y
Kuzuya
Kazuo
K
Kigawa
Junzo
J
Takeuchi
Satoshi
S
Tsuda
Hitoshi
H
Moriya
Takuya
T
Kikuchi
Yoshihiro
Y
D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis
D000077146:Irinotecan; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin; D002166:Camptothecin
Int J Gynecol Cancer. 2006 Jan-Feb;16(1):52-6
16445610
Jpn J Cancer Res. 2002 Jun;93(6):723-8
12079522
Cancer Lett. 1998 Jun 19;128(2):211-8
9683285
Int J Gynecol Cancer. 2003 Nov-Dec;13(6):735-40
14675308
Clin Cancer Res. 2005 Oct 1;11(19 Pt 1):6880-8
16203778
Gynecol Oncol. 2004 Jul;94(1):197-203
15262142
Am J Pathol. 2003 Dec;163(6):2503-12
14633622
Gynecol Oncol. 1996 Mar;60(3):412-7
8774649
Br J Cancer. 2006 May 22;94(10):1369-74
16641903
Int J Cancer. 1992 Feb 20;50(4):604-10
1537625
Gynecol Oncol. 2005 Jun;97(3):893-7
15894369
Gynecol Oncol. 2003 Mar;88(3):394-9
12648592
Gynecol Oncol. 2006 Aug;102(2):285-91
16516283
Cancer. 2000 Jun 1;88(11):2584-9
10861437
N Engl J Med. 2002 Jan 10;346(2):85-91
11784874
N Engl J Med. 1996 Jan 4;334(1):1-6
7494563
Cancer. 1996 Nov 15;78(10):2157-63
8918409
Jpn J Clin Oncol. 1999 Sep;29(9):434-7
10563197
Oncol Rep. 2000 Mar-Apr;7(2):327-31
10671681
Cancer Res. 1996 Feb 15;56(4):789-93
8631015
J Clin Oncol. 1991 Jul;9(7):1138-50
1904477
Jpn J Cancer Res. 1994 Sep;85(9):966-71
7961127
Gynecol Oncol. 1993 May;49(2):250-4
8504995