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Dose-dense paclitaxel plus carboplatin as neoadjuvant chemotherapy for advanced ovarian, fallopian tube, or primary peritoneal carcinomas

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Abstract

Purpose

Weekly dose-dense paclitaxel with carboplatin every 3 weeks (dose-dense TC) provides good efficacy, and neoadjuvant chemotherapy is common for advanced-stage disease. However, it is unclear the efficacy and safety of dose-dense TC as neoadjuvant chemotherapy. Therefore, we evaluated neoadjuvant dose-dense TC chemotherapy for advanced-stage ovarian carcinoma.

Methods

We retrospectively reviewed cases of ovarian carcinoma that were not suited for primary debulking surgery (2003–2014). The patients received neoadjuvant dose-dense TC chemotherapy, followed by interval debulking surgery and adjuvant chemotherapy.

Results

We identified 74 patients (mean age 60 years, range 39–85 years). The FIGO stages were IIIC (39/74, 52.7%) and IV (34/74, 45.9%). Fifty-six patients (75.6%) had a performance status of 0–1. The adverse events were grade 3/4 neutropenia (55.4%), anemia (44.6%), thrombocytopenia (21.6%), and peripheral neuropathy (8.1%); no treatment-related deaths were observed. Among the 66 patients who underwent debulking (89.2%), 55 patients (74.3%) achieved optimal debulking and 47 patients (63.5%) achieved complete resection. The median progression-free and overall survivals were 19.0 months (95% CI 16.2–23.7 months) and 55.1 months (95% CI 44.6 months to not estimable), respectively. A performance status of 2–3 was independently associated with poor prognosis (hazard ratio 3.84; p = 0.001).

Conclusions

Neoadjuvant dose-dense TC chemotherapy was effective (complete resection in >60% of cases) and tolerable for advanced-stage ovarian carcinoma.

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Acknowledgements

We thank all medical staffs who contributed to treatment of patients.

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Authors and Affiliations

  1. Department of Medical Oncology, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8677, Japan

    T. Ebata

  2. Department of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    T. Ebata, M. Yunokawa, A. Shimomura, T. Shimoi, M. Kodaira, K. Yonemori, C. Shimizu, Y. Fujiwara & K. Tamura

  3. Department of Pharmacy, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    S. Bun

  4. Department of Gynecology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    T. Kato

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  1. T. Ebata
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  2. M. Yunokawa
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Correspondence to M. Yunokawa.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Ebata, T., Yunokawa, M., Bun, S. et al. Dose-dense paclitaxel plus carboplatin as neoadjuvant chemotherapy for advanced ovarian, fallopian tube, or primary peritoneal carcinomas. Cancer Chemother Pharmacol 78, 1283–1288 (2016). https://doi.org/10.1007/s00280-016-3187-3

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  • DOI: https://doi.org/10.1007/s00280-016-3187-3

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