THERAPY OF OVARIAN-CANCER WITH CISPLATINU M AND TREOSULFAN

In a prospective study at the Department of Obstetrics and Gynaecology , University of Erlangen, 58 patients with advanced ovarian carcinoma FIGO II-IV were treated with a combination of surgical and cytostatic therapy in a curative intention. All patients underwent an extended pr imary operation with maximal tumor debulking and were treated afterwar ds with 4 chemotherapy cycles of cisplatinum (100 mg/m2) and treosulfa ne in a monthly interval. Three to four weeks after this therapy a sec ond look operation was performed. 46 patients received a second look o peration. During the primary operation in 19 patients the tumor was ma croscopic fully removed (R0), in 8 patients the tumor rest was less th an 2 cm (R1), 11 patients had a tumor rest of more than 2 cm (R2). The second look operation proved in 24 patients a complete remission, in 13 patients only small tumor rests were found during the second look o peration (PR), 2 patients had a no change and 7 patients an early prog ression. The response rate (CR + PR + NC) proven by second look surger y was 85 % (39/46). The 12 patients without a second look operation ha d at this time 1 complete remission, 1 partial remission, 6 NED and 4 patients an early progression. After a median follow up of 18 months ( 5 to 55 months) 17 patients in addition to the 11 patients with early progression suffered from a recurrence. 23 patients died. 30 patients are recurrence free. The side effect rate in this trial is mainly due to cisplatinum. The main side effect is the haemotoxicity. Nephrotoxic side effects and alopecia seldomly appeared. The subjective tolerance concerning gastrointestinal symptoms was good under antiemetic protec tion. Therefore treosulfane seems to be suitable for the treatment of metastatic ovarian cancer.