title: Advanced (>second) line chemotherapy in the treatment of patients with recurrent epithelial ovarian cancer.
abstract: OBJECTIVE
  To explore the pattern of chemotherapy (beyond the second-line) used to treat patients with recurrent epithelial ovarian cancer (including primary peritoneal carcinoma).
  
  
  METHODS
  This retrospective study included 156 patients with recurrent epithelial ovarian cancer and primary peritoneal carcinoma who were treated in the Gynecologic Oncologic Department at Meir Medical Center between November 1995 and December 2003. Clinical characteristics and data regarding the surgery, chemotherapy, and response to treatment were abstracted from the patients' medical records to determine patient response to advanced lines of chemotherapy for recurrent epithelial ovarian cancer.
  
  
  RESULTS
  Of the 156 patients, 63 (40%) were treated beyond second-line chemotherapy. Clinical response to third-line chemotherapy was 11.9% (6.8% had complete clinical response and 5.1% partial clinical response) and 3.4% had stable disease. A total of 17% did not show immediate progression, with a median progression free-interval of 1.5 months. A drastic decline in clinical response rates was shown beyond third-line chemotherapy. Any response to treatment in more advanced lines was consistently under 5%.
  
  
  CONCLUSIONS
  These results imply that advanced lines of chemotherapy are associated with low response rates, although a small percentage of patients showed some clinical response or remained with stable disease at the end of treatment. Along with patient preferences, the advantages and disadvantages of continued therapy should be considered, for the side effects of each treatment cannot be overlooked.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba Israel, affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. ilan.bruchim@gmail.com
authors.forename: Ilan
authors.initials: I
authors.lastname: Bruchim
authors.forename: Osnat
authors.initials: O
authors.lastname: Jarchowsky-Dolberg
authors.forename: Ami
authors.initials: A
authors.lastname: Fishman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D010534:Peritoneal Neoplasms / Q000188:drug therapy; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000706:statistics & numerical data*
chemical_list: D000970:Antineoplastic Agents