Six Hungarian gyneco-oncological centers undertook the evaluation of dose escalation in cytoprotection in a multicenter prospective study. 273 treatment cycles of 52 patients with advanced ovarian cancer were evaluated. In 64 cycles 750 mg/sqm cyclophosphamide + 75 mg/sqm cisplatin (group A) and in 209 cycles 1000 mg/sqm cyclophosphamide + 100 mg/sqm cisplatin (group B) were administered. The dose of Amifostine was 910 mg/sqm in both the groups. The distribution according to the most relevant prognostic factors was comparable between the groups. The maximum toxicity registered from laboratory examinations repeated at weekly intervals and evaluated according to the WHO 5 grade scale was the basis for comparison between group A and group B. The nadir value of serum haemoglobin level shows that the 25% dose elevation resulted in a reduction of 3.8% in the frequency of the favourable and mild G0-G1-G2 grades. G4 toxicity was not registered in either of the groups. The comparison of nadir values of leucopenia registered demonstrates that the frequency of G3 and G4 toxicity did not increase in spite of dose elevation (Group A: 28.1% versus group B: 21.4%). The proportion of cycles without thrombocytopenia (G0) showed a 4% decrease in group B (78%) as compared to group A (74%). Cycles without any registered renal toxicity (G0) showed a 11.8% decrease in group B as compared to group A, G4 toxicity was not registered. Postponed cycles were not registered in group B and 1 cycle was postponed in group A. Hospitalisation due to fever, neutropenia and nephrotoxicity did not occur in any of the groups. Blood transfusion or erythropoietin was administered in 18% of the cycles in group B. Antibiotic therapy was not registered in group A and it was given in 1.4% of the cases in group B. No CSF was administered in group A and only in 6 cycles out of 209 (2.9%) in group B it had to be given. The proportion of the best and still favourable performance scores (WHO G0, G1) registered was 55/64 cycles (86%) in group A and 188/209 (90%) in group B. The remission rate (CR + PR) achieved was 58.3% in group A and 65% in group B. The conclusion of the study could be that the CP chemotherapy in an elevated dose combined with Amifostine cytoprotection represents a good possibility for optimalisation of CP therapy. The 25% dose increase improved the remission rate without leading to a significant increase in the grade and frequency of toxicity and without deteriorating the quality of life.
|Translated title of the contribution||Conventional and high-dose cyclophosphamide + cisplatin (CP) chemotherapy of advanced stage ovarian cancer under Amifostine cytoprotection|
|Number of pages||10|
|Journal||Magyar Noorvosok Lapja|
|Publication status||Published - Dec 1 1999|
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynaecology