High-dose chemotherapy with hematopoietic rescue in patients with stage III to IV ovarian cancer: Long-term results

Purpose: A series of 53 patients with poor-prognosis epithelial ovarian cancer treated with high-dose chemotherapy (HDC) followed by hematopoietic rescue was retrospectively studied from the day of diagnosis for toxicity and long-term survival analysis. Patients and Methods: Patients were treated with surgery followed by cisplatin combination chemotherapy. After second-look operation (SLO), HDC was administered: 23 patients received melphalan (140 mg/m(2) on day 1) and 30 patients received a combination of carboplatin (400 mg/m(2) on days 1 to 4) and cyclophosphamide (1.6 g/m(2) on days 1 to 4). After HDC, autologous stern-cell transplantation was performed for hematologic support. Results: Orae patient died of cardiac failure after HDC, bur the acute toxicity was acceptable for the other patients, With a median follow-up of 81.5 months, the 5-year overall survival rate for the 53 patients was 59.9% and the disease-free survival (DFS) rate at 5 years was 23.6%. Twenty-four patients (45.3%) were alive, 12 with no evidence of disease and 12 with recurrent disease. The best results were achieved in 19 patients with pathologic complete response at SLO (74.2% 5-year overall survival; 32.8% 5-year DFS). Conclusion: HDC followed by autologous stem-cell support is a well-tolerated therapeutic approach for pars patients with poor-prognosis ovarian carcinoma. in this report, the 59.9% survival of 53 patients at 5 years must be compared to the 20% to 30% 5-year survival observed offer conventional therapy. These results should be confirmed by an ongoing prospective randomized trial. (C) 1997 by American Society of Clinical Oncology.