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  • 1
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. Hoskins PJ, O'Reilly SE, Swenerton KD. The ‘failure free interval’ defines the likelihood of resistance to carboplatin in patients with advanced epithelial ovarian cancer previously treated with cisplatin: relevance to therapy and new drug testing. Int J Gynecol Cancer 1991; 1: 205–208.An earlier phase II trial of second-line carboplatin in patients (n= 46) with epithelial ovarian carcinoma previously treated with cisplatin was re-analyzed using the period from initial diagnosis to the first evidence of progression (the ‘failure free interval’) as a predictor of the probability of response to carboplatin. The rationale was to try to improve our ability to define resistant patients. No responses were seen if the failure free interval was less than 24 months (0/32) whilst 63% (9/14) responded if it was more than 24 months (6 complete and 3 partial responses).
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Suite 208, Cambridge, MA 02142, USA : Blackwell Scientific Publications Inc.
    International journal of gynecological cancer 2 (1992), S. 0 
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Etoposide (VP16) was administered intravenously at a dose of 150 mg/m2 daily for 2 days every 2 weeks to 24 patients with progressing epithelial ovarian carcinoma which was resistant to platinum analogues. Using standard response criteria there were five clinical partial responses (21%, 95% confidence limits 5–37%) and three disease stabilizations. However, the aim of our study was to determine if etoposide was non-cross-resistant with platinum analogues and therefore we also developed additional response criteria based on serial CA 125 levels. This was to enable us to differentiate within the heterogeneous group of responses that form the stable disease category. Nine of 23 patients (39%, 95% confidence limits 19–59%) demonstrated a fall (all rising prior to etoposide) and of these, three had a serologic partial remission (65% or greater fall). The serologic and clinical responses were strongly correlated. Falling CA 125 levels occurred in the eight patients with either clinical partial responses or disease stabilizations.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We placed patients with invasive epithelial ovarian cancer into four distinct prognostic groups: ‘low’, ‘moderate’, ‘high’ and ‘extreme’ risk. The ‘moderate-risk’ group contained all residual negative, stage I and II patients with two exceptions: stage Ia or b, grade 1 cancers and grade 3 cancers. They were treated with primary surgery, usually including bilateral salpingo-oophorectomy, hysterectomy and omentectomy. Chemotherapy was then given (cisplatin at 100 mg m−2 every 2 weeks for three cycles) followed by pelvi-abdominal irradiation (2250 cGy in 10 fractions to the pelvis and 2250 cGy in 22 fractions to the whole abdomen including pelvis). An early cohort with ascites or positive washings instead received six cycles of cisplatin and cyclophosphamide at 75 mg m−2 and 600 mg m−2 every 4 weeks with the same pelvi-abdominal irradiation sandwiched between cycles 3 and 4. One-hundred and nine patients were treated between November 1983 and December 1989. Median follow-up was 4.7 years (range 0.7–9 years). The 5-year actuarial overall and failure-free survivals were 81% and 76%, respectively. Chronic toxicity, although usually minor, included 15% with peripheral neuropathy or ototoxicity and 23% with chronic abdominal complaints. Our combined-modality results are similar to those obtained by other centers utilizing either pelvi-abdominal irradiation alone or cisplatin-based chemotherapy alone.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Suite 500, 5th Floor, 238 Main Street, Cambridge, Massachussetts 02142, USA : Blackwell Science Inc.
    International journal of gynecological cancer 5 (1995), S. 0 
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Patients with epithelial ovarian cancer (EOC) referred to our institution are stratified into risk groups based on their stage, grade and presence of residual cancer, with a specific treatment policy for each group. One-hundred and thirty-one patients with no visible residual tumor following primary surgery and either stage I, grade 3; stage II, grade 3; or stage III, any grade EOC were treated between November 1983 and the end of December 1991. Regimen A (cisplatin 75 mgm−2 and cyclophosphamide 600 mgm−2 intravenously every 4 weeks for 6 cycles with abdominopelvic irradiation between cycles 3 and 4) was used until April 1989 and was then replaced with Regimen B (cisplatin 75 mgm−2 intravenously every 3 weeks for 6 cycles). The 5-year actuarial overall and failure-free survivals were 78% and 64% respectively. Multivariate analysis identified increasing stage and treatment with Regimen B as independent adverse prognostic factors for failure-free survival. The importance of treatment regimen reached statistical significance for the stage I patients (P = 0.04) but not stage II (P = 0.11) or stage III (P = 0.79). It is possible to undertreat EOC as shown by the inferior results achieved with Regimen B (single agent cisplatin) compared to Regimen A (cisplatin-cyclophosphamide, irradiation). This effect of treatment regimen was particularly important for the lower-stage patients. Our postulate is that treatment resistant clones are less regularly present in lower-stage patients, and that a certain minimum amount of treatment is required to eliminate all the sensitive cancer.
    Type of Medium: Electronic Resource
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