Neoadjuvant Chemotherapy for Advanced Epithelial Ovarian Cancer
Keywords:
Ovarian neoplasms, neoadjuvant therapy, observational studiesAbstract
Objective: To describe the experience at the National Cancer Institute (NCI) on the use of neoadjuvant chemotherapy as primary treatment for epithelial ovarian cancer among patients in stages IIIC and IV.
Methods: We conducted a descriptive retrospective study (case series type) of patients diagnosed with epithelial ovarian cancer in stages IIIC and IV, treated at the NCI from January 1, 2003 to December 31, 2006, who underwent neoadjuvant chemotherapy as primary treatment. Demographic characteristics and clinical outcomes are described.
Results: Seventeen patients who fulfilled the abovementioned criteria were selected. Once neoadjuvant chemotherapy ended, 5 patients (29.4%) achieved complete or partial clinical response; 4 (23.8%) remained in stable condition, and 8 (47.6%) showed signs of progressive illness. Interval debulking surgery was performed on objective response patients. Maximum cytoreduction was achieved in 5 patients (100%); first relapse was reported at month 18 of follow-up; 2 disease-free survivors were identified in December, 2007; 8 (49%) reported some degree of non-severe chemotherapy-related toxicity. No mortality was related to chemotherapy, no postsurgical complications were observed and no patient required advanced support management.
Conclusions: Neoadjuvant chemotherapy, followed by optimal interval debulking surgery among selected patients, can be an alternative treatment for advanced epithelial ovarian cancer among women with irresecability or the critically ill. Further studies with improved design are required to confirm these findings.
Author Biographies
Juan Avendaño, Instituto Nacional de Cancerología
Grupo de Ginecología Oncológica. Instituto Nacional de Cancerología. Bogotá, Colombia.
Giancarlo Buitrago, Instituto Nacional de Cancerología
Grupo de Investigaciones Clínicas. Instituto Nacional de Cancerología. Bogotá, Colombia.
Pedro Ramos, Instituto Nacional de Cancerología
Grupo de Oncología Clínica. Instituto Nacional de Cancerología. Bogotá, Colombia.
Óscar Suescún, Instituto Nacional de Cancerología
Grupo de Ginecología Oncológica. Instituto Nacional de Cancerología. Bogotá, Colombia.
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