Annals of Oncology Advance Access originally published online on August 30, 2007
Annals of Oncology 2007 18(12):1985-1989; doi:10.1093/annonc/mdm376
© 2007 European Society for Medical Oncology
gynecologic tumors |
Results of a prospective dose-intensive regimen in 27 patients with small cell carcinoma of the ovary of the hypercalcemic type
1 Department of Medical Oncology
2 Department of Pathology
3 Department of Biostatistics, Institut Gustave-Roussy, Villejuif
4 Centre Hospitalier de Brive
5 Department of Medical Oncology, Centre Eugène-Marquis, Rennes
6 Centre Georges-François Leclerc, Dijon
7 Department of Medical Oncology, Centre Oscar Lambret, Lille
8 Hôpital de la Pitié Salpétrière, Paris
9 Centre François Baclèse, Caen
10 Centre Hospitalier de Colmar
11 Department of Surgery, Institut Gustave-Roussy, Villejuif, France
* Correspondence to: Dr P. Pautier, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France. Tel: +33-1-42-11-45-17; Fax: +33-1-42-11-52-14; E-mail: pautier{at}igr.fr
Background: The evaluation of first-line intensive combination therapy in small cell carcinoma of the ovary (SCCO).
Patients and methods: Debulking surgery; four to six cycles of chemotherapy with cisplatin (P) 80 mg/m2 day 1, adriamycin (A) 40 mg/m2 day 1, vepeside (V) 75 mg/m2/day days 1–3, cyclophosphamide (EP) 300 mg/m2/day days 1–3, every 3 weeks and granulocyte colony-stimulating factor with, in case of a complete remission, high-dose chemotherapy with carboplatin, vepeside, cyclophosphamide and stem-cell support.
Results: Twenty-seven patients (median age 25 years); International Federation of Gynecology and Obstetrics stage: five I, four IIC, 17 IIIC–IV and one unknown. Twenty patients underwent complete surgery. Eight patients progressed under chemotherapy. Among 18 patients in complete response (CR), 10 received high-dose chemotherapy (CT) (three stem-cell collection failures, two protocol violations, two disease progression and one refusal). The main grade 3–4 toxic effects were hematologic. There were eight relapses among the 18 CR, four of which were pelvic alone. Among the 27 patients, 13 died and 10 patients are in CR1, three in CR2. The median follow-up is 37 months (8–166) and the median duration of the 18 CR is 30 months (5–111). Overall survival at 1 and 3 years is 58% [confidence interval (CI) 40% to 75%] and 49% (CI 30% to 67%).
Conclusions: Initial dose-intensive therapy achieves interesting overall survival in SCCO.
Key words: chemotherapy, high-dose therapy, ovarian cancer, small cell carcinoma
Received for publication April 16, 2007. Revision received June 26, 2007. Accepted for publication July 2, 2007.