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Japanese Journal of Clinical Oncology Advance Access published online on May 27, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyn034
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© 2008 The Author(s)
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Are Three Additional Cycles of Chemotherapy Useful in Patients with Advanced-stage Epithelial Ovarian Cancer After a Complete Response to Six Cycles of Intravenous Adjuvant Paclitaxel and Carboplatin?{dagger}

Hee Seung Kim, Noh-Hyun Park, Hyun Hoon Chung, Jae Weon Kim, Yong-Sang Song and Soon-Beom Kang

Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea

For reprints and all correspondence: Noh-Hyun Park, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University, 28 Yungun-Dong, Chongno-Gu, Seoul 110-744, Republic of Korea. E-mail: pnhkhr{at}snu.ac.kr

Received December 17, 2007; accepted April 7, 2008

Background: To evaluate the efficacy of three additional cycles of chemotherapy in patients with the International Federation of Gynecology and Obstetrics Stage III or IV, who achieved a complete response after six cycles of intravenous adjuvant paclitaxel/carboplatin after surgery.

Methods: The clinical data of 94 patients with complete response after six cycles of adjuvant paclitaxel/carboplatin after surgery between January 1997 and March 2007 were reviewed retrospectively. Three additional cycles using the same chemotherapy were administered to 57 patients as consolidation chemotherapy (Group 1). Thirty-seven patients without the additional cycles served as controls (Group 2). Disease-free survival (DFS) and overall survival (OS) were evaluated using the Kaplan–Meier method with the log-rank test. The importance of consolidation chemotherapy as a prognostic factor affecting survival was examined using the Cox's proportional hazard analysis. The incidence of chemotherapy-induced hematological toxicities was compared between the two groups using chi-square test.

Results: Median DFS and mean OS were not significantly different between the two groups (15 versus 22 months, P = 0.703; 69 versus 73 months, P = 0.891, respectively). Consolidation chemotherapy was not a prognostic factor of survival although optimal debulking surgery and lower value of serum CA-125 levels after six cycles of the chemotherapy were prognostic factors improving DFS (P < 0.01). Grade 3 or 4 leukopenia was more common in patients treated with consolidation chemotherapy than in those not treated (50.9 versus 21.6%, P = 0.004).

Conclusion: Consolidation chemotherapy using paclitaxel/carboplatin may be inefficient and relatively toxic to advanced-stage epithelial ovarian cancer patients with complete response to six cycles of the same chemotherapy after surgery.

Key Words: consolidation chemotherapy • paclitaxel • carboplatin • ovarian cancer

{dagger} Presented at the 15th International Meeting of The European Society of Gynaecological Oncology, October 29, 2007


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