Weekly Paclitaxel and Carboplatin for Patients with Advanced Ovarian Cancer

Purpose: The purpose of this study was to evaluate the efficacy and toxicity of dose-dense weekly paclitaxel plus 3- weeks carboplatin as a neoadjuvant and adjuvant therapy for primary epithelial ovarian cancer.Patients and Methods: Fifty patients with histologically proven potentially unresectable stages IIb-IV 1ry epithelial ovarian cancer attending the Outpatient Clinics of Clinical Oncology and Nuclear Medicine Department, Mansoura University Hospital during the period from Aug. 2005 to Oct. 2009 were enrolled. All patients were treated with neoadjuvant paclitaxel 100mg/m2 d1, 8 15 plus carboplatin AUC 6 given on day 1 of a 21-day cycle (PC regimen) for 3 cycles followed by interval cytoreductive surgery and an additional 3-6 cycles of adjuvant PC regimen.Results: Thirty six (72%) patients were presented with stage III-IV disease. At the end of neoadjuvant PC, 64% had a radiological complete response (CR) and 32% had a bio-chemical CR. Optimal interval cytoreduction was feasible in 41/50 patients (82%) and pathological CR was established in 15/50 patients (30%). Post therapy radiological CR was achieved in 43/50 patients (86%) and biochemical CR in 41/50 patients (82%). Median time to progression (TTP) and median overall survival (OS) were 22 and 49 months respec-tively. Neutropenia was the most common haematological toxicity developed in 34 patients of whom 12 had G3/4. Grade 3 peripheral neuropathy was observed in 2 patients and G1/2 myalgia/arthralgia in 10 patients. Ninety-two percent of patients experienced G1/2 alopecia.Conclusion: Dose dense weekly paclitaxel plus 3-weeks carpoblatin is an effective and well tolerated neoadjuvant and adjuvant regimen. Combined with interval cytoreductive surgery, it may be a better alternative treatment option to the standard 1ry debulking surgery and sequential conventional 3-week regimen in patients with advanced epithelial ovarian cancer.