gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

A randomized multicenter Phase II study on neoadjuvant chemotherapy with Carboplatin and Docetaxel in advanced ovarian carcinomas (PRIMOVAR)

Meeting Abstract

  • corresponding author presenting/speaker Tjoung-Won Park - Universitätsfrauenklinik, Bonn, Deutschland
  • Fritz Jänicke - Universitätsfrauenklinik, Hamburg
  • Olaf Ortmann - Universitätsfrauenklinik, Regensburg
  • Jörn Hilfrich - Henriettenstiftung Neu-Bethesda, Hannover
  • Georg-Peter Breitbach - Städtisches Klinikum, Neunkirchen
  • Cornelia Höss - Kreisklinikum, Ebersberg
  • Volker Möbus - Städtische Kliniken, Frankfurt Höchst
  • Klaus Dietrich - Universitätsfrauenklinik, Lübeck
  • Christoph Thomssen - Universitätsfrauenklinik, Halle
  • Walther Kuhn - Universitätsfrauenklinik, Bonn

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocOP340

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dkk2006/06dkk450.shtml

Veröffentlicht: 20. März 2006

© 2006 Park et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: In the past years the concept of neoadjuvant chemotherapy followed by laparotomy has emerged for patients with advanced ovarian cancer and unfavorable prognosis (e.g. diffuse peritoneal carcinosis). In a recent study on neoadjuvant chemotherapy higher tumor resection rates and longer median survival were demonstrated in patients with advanced ovarian carcinoma and ascites >500ml. Most studies use three cycles of preoperative chemotherapy. However, chemoresistant tumorclones may be induced by increasing number of preoperative chemotherapy cycles. The purpose of this study is to evaluate the optimal number of cycles prior to interval laparotomy.

Material and Methods: 67/73 patients with advanced serous ovarian carcinoma (FIGO IIIc n=48, FIGO IV n=19) and ascites >500ml were randomized into two arms, receiving either 2 (n=33) or 3 (n=34) cycles of Carboplatin (AUC5) and Docetaxel (75mg/m2) before debulking surgery. Postoperatively, they received either 4 or 3 additional cycles. Response rate, postoperative residual tumor and quality of life (QOL) were evaluated.

Results: Surgical response was assessed during interval laparotomy. At present 32 patients underwent tumordebulking. Partial remission was observed in 28/32 patients irrespective of the number of preoperative chemotherapy cycles. Two patients in each arm showed stable disease. Optimal cytoreduction was achieved in 25/32 patients. No severe adverse events were reported and QOL improved considerably during preoperative chemotherapy. Six of 73 patients were not eligible. Two patients were excluded due to therapy-unrelated events. In 4 patients ovarian cancer was excluded by laparoscopy prior to neoadjuvant chemotherapy.

Conclusions: Neoadjuvant chemotherapy followed by laparotomy was safe and well tolerated. Diagnostic laparoscopy prior to neoadjuvant chemotherapy allowed differentiation of primary ovarian cancers from tumors of other origin. In these cases laparotomy could be circumvented. Optimal tumor reduction was achieved in a significant number of patients. Response rate, postoperative residual tumor and QOL were essentially the same in both arms. Our data indicate that two cycles of preoperative chemotherapy may be the preferential choice of therapy for future studies.