HIGH-DOSE CHEMOTHERAPY WITH HEMATOPOIETIC RESCUE IN PATIENTS WITH STAGE-III TO STAGE-IV OVARIAN-CANCER - LONG-TERM RESULTS

Purpose: A series of 53 patients with poor-prognosis epithelial ovaria n cancer treated with high-dose chemotherapy (HDC) followed by hematop oietic rescue was retrospectively studied from the day of diagnosis fo r toxicity and long-term survival analysis. Patients and Methods: Pati ents were treated with surgery followed by cisplatin combination chemo therapy. After second-look operation (SLO), HDC was administered: 23 p atients received melphalan (140 mg/m(2) on day 1) and 30 patients rece ived a combination of carboplatin (400 mg/m(2) on days 1 to 4) and cyc lophosphamide (1.6 g/m(2) on days 1 to 4). After HDC, autologous stern -cell transplantation was performed for hematologic support. Results: Orae patient died of cardiac failure after HDC, bur the acute toxicity was acceptable for the other patients, With a median follow-up of 81. 5 months, the 5-year overall survival rate for the 53 patients was 59. 9% and the disease-free survival (DFS) rate at 5 years was 23.6%. Twen ty-four patients (45.3%) were alive, 12 with no evidence of disease an d 12 with recurrent disease. The best results were achieved in 19 pati ents with pathologic complete response at SLO (74.2% 5-year overall su rvival; 32.8% 5-year DFS). Conclusion: HDC followed by autologous stem -cell support is a well-tolerated therapeutic approach for pars patien ts with poor-prognosis ovarian carcinoma. in this report, the 59.9% su rvival of 53 patients at 5 years must be compared to the 20% to 30% 5- year survival observed offer conventional therapy. These results shoul d be confirmed by an ongoing prospective randomized trial. (C) 1997 by American Society of Clinical Oncology.