Chemotherapy in patients with recurrent or refractory epithelial ovarian cancer
Satthapong, D.; Tangjitgamol, S.; Manusirivithaya, S.; Pataradool, K.
Journal of the Medical Association of Thailand 90(3): 411-419
2007
ISSN/ISBN: 0125-2208 PMID: 17427513 Document Number: 2815
Objectives: To evaluate the response rates, progression-free survival, and overall survival of patients with epithelial ovarian carcinoma who were treated with chemotherapy after being resistant to or had recurrence after first-line chemotherapy.Material and Method. Clinical and pathological data of all patients with epithelial ovarian carcinoma who received chemotherapy in the second-setting at the Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital from January 1994 to December 2005 were reviewed.Results: During the study period, 61 ovarian carcinoma patients met the inclusion criteria. All patients had primary surgery, not responded to or had recurrence after first-line chemotherapy, and received subsequent chemotherapy. Thirty-seven cases (60.7%) were considered as platinum-resistant and 24 cases as platinum-sensitive (39.3%). The overall response rate (RR) to subsequent chemotherapy was 23.0% (14 patients): complete response 18.0% (11 patients) and partial response 5.0% (three patients). Stable disease was achieved as the best response in 11 patients (18.0%). Thirty-six patients (59.6%) experienced disease progression. Median progression-free survival (PFS) of all 61 patients was 5.7 months (95%CI, 4.7-6.7 months) while median overall survival (OS) was 18.3 months (95%CI, 2.7-34. 0 months). Some prognostic factors were studied and found that patients with platinum-sensitive had a better response rate, longer PFS and OS than those with platinum-resistant diseases.Conclusion: Response rate of ovarian carcinoma to subsequent chemotherapy for resistant or recurrent diseases was modest. Median PFS and OS of the patients were less than and slightly longer than a year respectively. The patients who had platinum-sensitive diseases had a better prognosis in terms of RR, PFS, and OS than those with platinum-resistant disease.
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