Second-line Chemotherapy with Taxol Containing Regimen in Recurrent or Refractory Ovarian Carcinoma after Platinum-Based Chemotherapy

Kim, M H; Park, N H; Kim, Y B; Lee, C M; Kim, J W; Song, Y S; Kang, S B; Lee, H P

Abstract

Second-line Salvage chemotherapy with Taxol Containing Regimen in Recurrent or Refractory Ovarian Carcinoma after Platinum-Based Chemotherapy. OBJECTIVES: This study is to investigate the efficacy and toxicity of Taxol containing regimen used as a salvage therapy.
METHODS
Between April 1994 and October 1997, 31 patients aged 20~70 years (median 53) with recurrent or refractory ovarian carcinoma were given Taxol-containing regimen. Taxol was administered at a dose of 135 mg/m2 intravenously with cisplatin or carboplatin every 3 weeks. The patients who treated with Taxol only were received 175 mg/m2 intravenously with same interval. The median treatment cycle was 7.4 cycles (range, 3 to 12 cycles). Patient`s response were evaluated with tumor marker (CA-125) and CT or MRI before and after chemotherapy. Responses and toxicities were defined according to the Gynecologic Oncology Group criteria. RESULT: The overall clinical response rate was 35.5% (11/31), including 9 complete response (CR) and 2 partial response (PR). Better response was observed in patients who had response with prior platinum based chemotherapy (6/11, 54.5%) than who did not (5/20, 25%). The median duration of follow up was 13.4 months (range, 3 to 40 months) and the median progression free interval was 10.1 months (range, 1 to 22 months); 15.5 months (range, 11 to 22 months) in platinum sensitive group and 8.3 months (range, 1~16 months) in platinum resistant group. The most common and dose limiting toxicity was neutropenia, and grade 4 toxicity occurred in 10% of courses.
CONCLUSION
Taxol containing regimen is useful combination chemotherapy in patients with previously platinum-sensitive patients with acceptable toxicity, but has limited role in chemo-refractory cases. Further prospective randomized trials are required to assess the optimal role of this drug in the management of ovarian cancer.