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Cisplatin - cyclophosphamide regimen

Abstract: Cyclophosphamide plus cis-platinum in combination: treatment program for stage III or IV ovarian carcinoma.

A randomized prospective comparison of treatment with cyclophosphamide and that with cyclophosphamide and cisplatinum, each in 21 patients with advanced ovarian cancer, has shown that the time to progression of tumor and the duration of survival were markedly improved in the patients receiving the combination chemotherapy. Cytoreductive surgery was performed in most of the patients in the study before the chemotherapy regimen was initiated. Second-look surgery was performed after a year of chemotherapy. The chemotherapy was administered on an outpatient basis, without excessive toxicity. At 2 years, 52.4% of the patients receiving combination therapy had no progression of tumor, whereas 9.5% had no progression of tumor in the group of patients receiving a single alkylating agent. Survival at 2 years was 61.9% for the combination chemotherapy group and 19.0% for those treated with cyclophosphamide alone. The study demonstrates a striking superiority of combination chemotherapy over single-agent chemotherapy in patients with advanced ovarian cancer.

References

Decker DG, Fleming TR, Malkasian GD Jr, Webb MJ, Jeffries JA, Edmonson JH. Cyclophosphamide plus cis-platinum in combination: treatment program for stage III or IV ovarian carcinoma. Obstet Gynecol. 1982 Oct;60(4):481-7.

Regimen

Original regimen as described by Decker:

Cyclophosphamide....... 1000 mg / M2 IV day 1
Cisplatin....... 50 mg / M2 IV day 1
FREQUENCY 21 days

Decker DG et al. Obstet Gynecol. 1982 Oct;60(4):481-7.

More recent regimens:

Cyclophosphamide....... 600 mg / M2 IV day 1
Cisplatin....... 100 mg / M2 IV day 1
FREQUENCY 21 days

Alberts et al. J Clin Oncol 1992; 10:706 - 717.

Cyclophosphamide....... 750 mg / M2 IV day 1
Cisplatin....... 75 mg / M2 IV day 1
FREQUENCY every 21 days

McGuire et al. NEJM 1996; 334:1 - 6.


     
  Summary Cisplatin - cyclophosphamide vs. cyclophosphamide in stage III & IV ovarian cancer.
  Progression Free Survival @ 2 years 52.4% v. 9.5%
  Overall Survival @ 2 years 61.9% v. 19.0%.
     

Article reviewed by:

Dr. Tamer Fouad, M.D.

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