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Intensified dose of cyclophosphamide with G-CSF support versus standard dose combined with platinum in first-line treatment of advanced ovarian cancer a randomised study from the GINECO group.
- Source :
- British Journal of Cancer; 11/5/2007, Vol. 97 Issue 9, p1200-1205, 6p, 1 Diagram, 3 Charts, 2 Graphs
- Publication Year :
- 2007
-
Abstract
- ICON3 trial results have suggested that CAP and carboplatin-taxol regimens as first-line treatment of advanced ovarian cancer (AOC) yield similar survival. We explored the impact of increased dose of cyclophosphamide in a modified CAP regimen on the disease-free survival (DFS) and overall survival (OS) of AOC patients. From February 1994 to June 1997, 164 patients were randomised to receive six cycles every 3 weeks of either standard CEP (S) combining cyclophosphamide (C), 500 mg m(-2), epirubicin (E) 50 mg m(-2), and cisplatin (P) 75 mg m(-2) or intensive CEP (I) with E and P at the same doses, but with (C) 1800 mg m(-2) and filgrastim 5 mug kg(-1) per day x 10 days. Response was evaluated at second-look surgery. Patient characteristics were well balanced. Except for grade 3-4 neutropaenia (S: 54%, I: 38% of cycles), Arm1 presented a significantly more important toxicity: infection requiring antibiotics, grade 3-4 thrombocytopaenia, anaemia, nausea-vomiting, diarrhoea, mucositis. Median follow-up was 84 months. DFS (15.9 vs 14.8 months) and OS (33 vs 30 months) were not significantly different between S and I (P>0.05). Increasing cyclophosphamide dose by more than 3 times with filgrastim support in the modified CAP regimen CEP induces more toxicity but not better efficacy in AOC. [ABSTRACT FROM AUTHOR]
- Subjects :
- CLINICAL drug trials
GRANULOCYTE-colony stimulating factor
COLONY-stimulating factors (Physiology)
RECOMBINANT proteins
OVARIAN cancer
CANCER treatment
THERAPEUTIC use of antineoplastic agents
OVARIAN tumors
CARBOPLATIN
PROGNOSIS
TREATMENT effectiveness
RANDOMIZED controlled trials
DOSE-effect relationship in pharmacology
ENDOMETRIAL tumors
CISPLATIN
CYCLOPHOSPHAMIDE
TUMORS
STATISTICAL sampling
LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 00070920
- Volume :
- 97
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- British Journal of Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 27267643
- Full Text :
- https://doi.org/10.1038/sj.bjc.6604026