Ovarian tumours

Abstract

Ovarian cancer still has a poor prognosis and numerous pretreatment prognostic factors make it very difficult to compare results achieved with chemotherapy. In this paper, studies with randomized treatment plans in advanced ovarian cancer published in the last two years are reported. Then radiotherapy, combined chemo-irradiation therapy and chemoimmunotherapy in ovarian cancer are discussed and second line chemotherapy schemes are described. Because of the very contradictory results in the literature, the Austrian Collaborative Study Group for the Treatment of Ovarian Cancer was founded in 1980. To date 300 patients have been randomized by a specially adapted computer process balancing all relevant prognostic factors. In stage III and IV (160 patients), three randomized groups exist comparing adriamycin (A) and cyclophosphamide (C) with A and cis-platin and a so-called 'changing scheme' (A/P-V/C-HD-MTX). In the first evaluation a significant advantage was seen for the changing scheme, not only for remission rate and duration but also for survival time; at the last evaluation in May 1984 the changing scheme still remains superior to A/C and A/P, especially in patients with G1 tumours, without ascites, with liver metastases and a large postoperative tumour burden. The changing scheme also gives less toxicity than A/P; it may thus represent a small step towards a longer and better life for patients with ovarian cancer.