title: Exploring palliative treatment outcomes in women with advanced or recurrent ovarian clear cell carcinoma.
abstract: OBJECTIVE
  Clear cell carcinoma (CCC) of the ovary is increasingly recognized as responding poorly to chemotherapy (CT). This review examines the outcomes achieved with a variety of CT regimens, looking for evidence of activity that might guide the development of more effective treatments.
  
  
  METHODS
  A retrospective chart review of all cases of CCC referred to the BC Cancer Agency (BCCA) between 2000 and 2008 was conducted. Data were collected from those with primarily advanced disease and from those who recurred after adjuvant treatment. Outcomes were measured using broad definitions of treatment benefit (any objective or subjective evidence of disease control) in order to reflect the real-life use of palliative therapy.
  
  
  RESULTS
  There were 158 women with pure CCC. First-line therapy for advanced disease was delivered to 33 patients. Second- and third-line treatment was delivered to 47 and 25 patients, respectively. The total number of treatment courses was 105: 88 CT-alone courses, 14 radiation therapy (RT)-alone and 3 combined modality. Treatment benefit was recorded in 24% of patients receiving CT, 64% of patients receiving RT, and each who received combined modality treatment. There was no CT drug class identified as obviously efficacious.
  
  
  CONCLUSIONS
  Most patients with advanced or recurrent CCC have a low benefit-to-failure ratio from palliative CT. The role of RT and targeted agents must be explored to improve clinical outcomes for such patients.
authors.affiliation: Department of Medical Oncology, Vancouver BC, V5Z-4E6, Canada. jalbarrak@bccancer.bc.ca
authors.forename: J
authors.initials: J
authors.lastname: Al-Barrak
authors.forename: J L
authors.initials: JL
authors.lastname: Santos
authors.forename: A
authors.initials: A
authors.lastname: Tinker
authors.forename: P
authors.initials: P
authors.lastname: Hoskins
authors.forename: C B
authors.initials: CB
authors.lastname: Gilks
authors.forename: H
authors.initials: H
authors.lastname: Lau
authors.forename: K D
authors.initials: KD
authors.lastname: Swenerton
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy*; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel / Q000008:administration & dosage; D010166:Palliative Care / Q000379:methods*; D019772:Topotecan / Q000008:administration & dosage; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D018943:Anthracyclines; D003841:Deoxycytidine; D005047:Etoposide; D019772:Topotecan; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin; D000093542:Gemcitabine