Addition of epirubicin to conventional chemotherapy in patients with advanced ovarian cancer: sequential therapy - a retrospective evaluation

Authors: NEJAT ÖZGÜL, MEHMET FARUK KÖSE, HÜSEYİN LEVENT KESKİN, AHMET TANER TURAN, MUSTAFA ALPER KARALÖK, IŞIN ÜREYEN, NURETTİN BORAN, HAKKI GÖKHAN TULUNAY

Abstract: To evaluate the effectiveness of the addition of epirubicin to conventional chemotherapy as a first-line therapy for stage III–IV epithelial ovarian cancer. Materials and methods: A total of 132 patients who had undergone primary cytoreductive surgery between January 1998 and March 2003 were enrolled in the study. Twenty-four cases were excluded. Out of the remaining 108 subjects, 35 received epirubicin/paclitaxel/carboplatin (Group EPC) and 73 were treated with paclitaxel/platinum (cisplatin or carboplatin) (Group PC). Results: The median follow-up period was 66.5 months. The clinical complete response was 94% in the EPC group and 97% in the PC group. The recurrence rate in the first 6 months after treatment was significantly higher in the PC than the EPC group (47% vs. 23%, P = 0.018). Triplet chemotherapy was not found to improve 2- and 5-year disease-free survival (DFS) statistically. No significant difference in overall survival was observed between the 2 groups (80% vs. 83% at 2 years and 56% vs. 57% at 5 years for the PC and the EPC group, respectively). The main toxicity in both groups was hematological, and it was particularly severe in the EPC group. Conclusion: The addition of epirubicin to the standard treatment protocol yielded an improvement in the DFS rate that was not statistically significant and caused a tolerable increase in toxicity.

Keywords: Epithelial ovarian cancer, gynecological oncology, chemotherapy

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