Paclitaxel/carboplatin as first-line chemotherapy in advanced ovarian cancer: Efficacy and adverse effects with special consideration of peripheral neurotoxicity

Background: The aim of this study was to investigate the response and survi val probability of patients with advanced ovarian cancer treated with a com bination of paclitaxel and carboplatin as first-line chemotherapy. Addition ally we investigated the extent of adverse effects due to chemotherapy with special consideration for peripheral neurotoxicity. Materials and Methods: Thirty-seven women with epithelial ovarian cancer, treated with a combinat ion chemotherapy consisting of paclitaxel and carboplatin, were included in the analysis. A total of 234 courses of paclitaxel/carboplatin were applie d. Paclitaxel was administered at a close of 175 mg/m(2) infused over 3 hou rs, every 21 days. Carboplatin was administered at an area under the concen tration-time curve (AUC) of 6. Results: Thirty of the 37 patients responded to the chemotherapy, demonstrating an overall response of 81%. Seven patie nts died of the disease (19%). The mean overall survival was 20 months (25% quartile: 19, median and 75% quartile not reached). Thirteen patients (34% ) developed peripheral neurotoxicity. In 10 cases (76%) neurotoxicity occur red after the fifth and sixth chemotherapy cycle. In all cases of severe ne urotoxicity pathologic sensory nerve conduction-measurements were observed In one patient a weakness of the left leg was observed. Apart from alopecia , other adverse effects were rare Conclusion: This study confirmed the ther apeutic benefit of the combination of paclitaxel and carboplatin as first-l ine chemotherapy in patients with ovarian cancer. Neurologic toxicity, incr easing with every cycle of the chemotherapy, was a clinically significant a dverse effect in ou,study However; peripheral neuropathy mainly affected se nsory fibers, without involving motor nerves.