LONG-TERM FOLLOW-UP OF PATIENTS WITH ADVANCED OVARIAN-CARCINOMA TREATED WITH CHEMOTHERAPY

Background: The evolution of the management of advanced ovarian carcin oma over the last fifteen years has resulted from a number of well-des igned randomized trials involving large numbers of patients. Materials and methods: A critical review of long-term follow-up of patients ent ered onto eleven major randomized trials of advanced ovarian carcinoma has been performed. Results: In the pre-platinum era no long-term sur vival benefit was obtained with combination compared with single agent chemotherapy. When adding cisplatin to front-line therapy at least a short-term gain in terms of superior response rate and progression-fre e intervals is obtained compared with non-cisplatin combination chemot herapy. Survival data are more difficult to assess due to the use of c is-platin-containing salvage therapy. Cisplatin-based combination ther apy also offers enhanced patient benefit when compared with cisplatin alone. A slight advantage favouring anthracycline-containing therapy i s observed, whereas no advantage is obtained with alternating cisplati n and non-cisplatin regimens or by adding BCG. Conclusions: Platinum-b ased combination chemotherapy is clearly associated with improved resp onse rates and progression-free survival and, at least in some studies , better overall survival. At least six cycles of therapy should be gi ven. Such approaches should yield long-term survival rates of 10% or b etter for patients with large-volume disease and 20% or better for sma ll-volume disease.