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Background: Ovarian
cancer is the leading cause of death among all gynecologic cancers in developed
countries. The standard treatment for advanced ovarian cancer consists of
cytoreductive surgery associated with a platinum/paclitaxel-based chemotherapy.
Over than 50% of patients with advanced ovarian cancer will develop
recurrent disease. For those patients who have recurrence of disease at least six
months after initial therapy, the paclitaxel- platinum combination has been
shown to be a superior treatment to platinum monotherapy. However, many
patients develop clinically relevant neurotoxicity, frequently resulting in
treatment discontinuation. The efficacy and safety of an alternative regimen
that dose not show significant neurotoxicity were evaluated by comparing
gemcitabin- carboplatin with carboplatin in platinum sensitive recurrent
ovarian cancer patients in a Gynecologic Cancer InterGroup trial in Canada and
European Organization for research and treatment of Cancer Gynecological Cancer
Group. But this study was not done in Iran.
Methods: We performed a study with escalating doses of
gemcitabin combined with carboplatin in 21 patients. All patients who were treated in Vali-Asr
hospital between 2003- 2005 evaluated. Gemcitabin with dose of 800mg/m2 was given on days 1, 8 and 15 followed by one week rest period for a 28 day cycle.
Combine with carboplatin with AUC 4 given on day 2. All patients with surgically resected,
histologically confirmed epithelial ovarian cancer and who had failed first-
line platinum chemotherapy were allocated to this study.
Results: Median age was 49 years (range 23-78 years). Median follow-up was six months (range 4-22). Total of 87 cycles of
chemotherapy were administered with median number of four (range 2-6 cycles).
Thrombocytopenia (grade I) and leucopenia (grade I) were seen in 4.75% and 9.52% of patients.
Conclusion: Gemcitabin and carboplatin Combination was tolerated
in patients with recurrence of ovarian cancer.
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