HIGH-DOSE CHEMOTHERAPY WITH AUTOLOGOUS STEM-CELL SUPPORT FOR THE TREATMENT OF ADVANCED OVARIAN-CANCER - INITIAL EXPERIENCE IN UPPSALA AND TURKU

Background. With current standard-dose chemotherapy ovarian cancer is a chemosensitive but not chemocurable disease in the majority of cases . The widely used first-line chemotherapy including a platinum analogu e combined with cyclophosphamide results in response rates of 60-80%. However, only 10-20% of patients with advanced disease are alive 5 yea rs after the diagnosis. The efficacy of high-dose chemotherapy support ed by autologous stem cell transplantation (ASCT) is currently under i ntensive investigation. Methods. We report here our initial experience s of the use of high-dose chemotherapy supported by ASCT for patients with high-risk ovarian cancer. Two patients were treated at Uppsala Un iversity Hospital in 1992 and four patients at Turku University Centra l Hospital in 1994. Results. The first four patients treated either af ter heavy previous chemotherapy or recurrent disease relapsed within 5 -10 months. Two patients received high-dose therapy as part of first-l ine treatment. One of them had a relapse 18 months after therapy, the other one has been disease free for 28 months. No toxic deaths occurre d, but the patients had neutropenic febrile episodes and moderate to s evere gastrointestinal toxicity. Conclusions. Coordinated efforts in N ordic countries are indicated to evaluate the usefulness of high-dose therapy supported by ASCT in the treatment of advanced ovarian cancer.