Abstract
To study the response rate, toxicity profiles, and survival of refractory or recurrent epithelial ovarian cancer (EOC) patients treated with paclitaxel. Patients with refractory or recurrent EOC who were treated with paclitaxel between January 2002 and December 2011 at the Department of Obstetrics and Gynecology, Faculty of Medicine, Vajira Hospital were identified. Clinicopathological features of the patients including detailed data of paclitaxel treatment were collected. During the study period, a total of 44 patients were identified, with a mean age of 52.9±8.2 years. Some 13.6% (six patients) had refractory cancer to first-line chemotherapy while 86.4% (38 patients) had recurrent cancer. Among these, 35 (79.6%) and 9 (20.4%) patients were considered as platinum-sensitive and platinum-resistant, respectively. Three patients (6.8%) received fewer than 2 cycles of paclitaxel due to loss to follow-up, leaving 41 patients evaluable for response. The overall response rate observed in all 41 patients was 41.5% (17 patients; 12 complete and five partial responses): 12.5% or 1/8 patients with refractory or platinum-resistant cancer and 48.5% or 16/33 patients with platinum-sensitive disease. Stable disease was demonstrated in 17.0% (seven patients) while progressive disease was apparent in 41.5% (17 patients). Median time to progress was 4.5 months (range, 0.67- 58.6 months). Median progression-free survival was not reached while median overall survival was 16.3 months (95% confidence interval, 11.0 months -21.6 months). Common toxicities were neutropenia, neuropathy, and alopecia. Paclitaxel is an active agent for refractory or recurrent EOC. Neutropenia, neuropathy and alopecia are common side effects.
Highlights
Ovarian cancer is the third most common gynecologic cancer worldwide (Ferlay et al, 2010)
Stable disease was demonstrated in 17.0% while progressive disease was apparent in 41.5% (17 patients)
Data collected were: age, the International Federation of Gynecology and Obstetrics (FIGO) stage, tumor histopathology and grade, outcome of primary surgery, type of first-line chemotherapy and response of disease, status of platinum-sensitivity, number of cycles of paclitaxel, response rate and side effects of paclitaxel, and time to progression (TTP) which was obtained from the time from starting paclitaxel to the time of progressive or recurrent diseases
Summary
Ovarian cancer is the third most common gynecologic cancer worldwide (Ferlay et al, 2010). As an adjuvant chemotherapy for advance stage with suboptimal disease, paclitaxel/ platinum yielded response rates of 70-80% (Muggia et al, 2000). This drug combination has survival advantage over cisplatin/ cyclophosphamide which had been commonly used prior to a discovery of paclitaxel. To study the response rate, toxicity profiles, and survival of refractory or recurrent epithelial ovarian cancer (EOC) patients treated with paclitaxel. The overall response rate observed in all 41 patients was 41.5% (17 patients; 12 complete and five partial responses): 12.5% or 1/8 patients with refractory or platinum-resistant cancer and 48.5% or 16/33 patients with platinum-sensitive disease.
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