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Korean Journal of Obstetrics & Gynecology 2008;51(1):31-40.
Published online January 1, 2008.
The efficacy and toxicity of topotecan in combination with platinum in patients with recurrent epithelial ovarian cancer and primary peritoneal carcinomatosis.
Hang Jo You, Yong Man Kim, Shin Wha Lee, Jung Nam Lee, Dae Yeon Kim, Dae Shik Suh, Jong Hyeok Kim, Young Tak Kim, Joo Hyun Nam, Jung Eun Mok
1Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Korea.
2Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. ymkim@amc.seoul.kr
3Department of Obstetrics and Gynecology, Cheil Hospital, Seoul, Korea.
The aim of this study was to evaluate the efficacy and toxicity of topotecan, camptothecin analogue topoisomerase I inhibitor, as the combination therapy with platinum in patients with recurrent epithelial ovarian carcinoma and primary peritoneal carcinomatosis. METHOD: In this study, patients who were treated with topotecan between January 2000 and June 2007 at Asan Medical Center, Seoul, Korea were reviewed. Fifty-one patients with recurrent ovarian carcinoma and peritoneal carcinomatosis were included. These patients' data were analyzed by review of medical records and pathologic and laboratory reports retrospectively. Response was assessed by Response Evaluation Criteria in Solid Tumors (RECIST) criteria for patients with measurable disease and CA-125 response criteria for patients with non-measurable disease. The toxicities were evaluated according to NCI CTC (Common Toxicity Criteria) version 3.0. RESULTS: The mean age of patients was 53.4 years (ranged between 37 and 69). Forty-four patients had been evaluated by RECIST criteria. The overall response rate was 22.8% (10/44). Platinum-sensitive patients showed more favorable response rate (26.9%) than platinum-resistant patients (16.7%), however, it was not significant statistically (p=0.425). Platinum-sensitive group had significantly longer response duration (12.14 vs. 3.33 months, p=0.022) and time-to-progression (11.34 vs. 7.33 months, p=0.042) than platinum-resistant group. Heavily pretreated group, three or more prior regimens were used, had no significant differences from another group. The most common adverse effect of topotecan in combination with platinum was hematologic toxicity; grade 3/4 neutropenia was 30.6%, anemia was 42.7%, and thrombocytopenia was 8.37% in total 265 cycles of chemotherapy, however, it was tolerable. CONCLUSION: Topotecan in combination with platinum is considered as effective regimen with acceptable toxicity in treating recurrent epithelial ovarian carcinoma and primary peritoneal carcinomatosis who have failed previous treatment with platinum-containing chemotherapy.
Key Words: Topotecan, Platinum, Recurrent ovarian cancer, Peritoneal carcinomatosis

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