[Single topotecan or in combination with other chemotherapeutic agents for 18 recurrent advanced ovarian cancer patients].

OBJECTIVE

This study was designed to evaluate the efficacy and toxicity of topotecan hydrochloride, used singly or combined with other drugs in patients with recurrent advanced ovarian cancer.

METHODS

Eighteen ovarian cancer patients who had received cytoreductive operation 1 to 3 times and 8 to 18 courses of chemotherapy but still failed in DDP-based(86.3%) and Taxol-based(32.7%) as well as combined DDP and Taxol-based(30.7%) chemotherapy, were divided into 3 groups: 1. Topotecan 1.2 mg/m2 q.d.i.v. for 5 consecutive days every 3 weeks for a total of 6 patients and 14 courses. 2. Topotecan 0.7 mg/m2 q.d.i.v. for 5 consecutive days and cis-platin 20 mg/m2 q.d.i.v. for 3 consecutive days over 4 weeks and 3. Topotecan 0.7 mg/m2 q.d.i.v. for 4 consecutive days and taxol 100 mg/m2 q.d.i.v. for one day as well as cis-platin 20 mg/m2 q.d.i.v. for 3 consecutive days totalling 12 patients and 27 courses. All together 18 courses, median 2.7 courses, were given.

RESULTS

All 18 patients were evaluable. PR was achieved in 3 patients with a response rate of 16.7%. The main adverse effects were hematological toxicity, lasting for 3-27 days. Ten (55.6%) patients developed leucocytopenia Grade III-IV which occurred in 16(33.3%) courses. Six(33.3%) patients developed thrombocytopenia Grade III-IV which occurred in 8(16.7%) courses. Six(33.3%) patients developed RBC reduction Grade III which occurred in 8(16.7%) courses. Peripheral nerve inflammation was most serious in the non-hematologic toxicity.

CONCLUSION

Topotecan is effective in recurrent advanced ovarian cancer patients who have failed in DDP or/and taxol-based regimes. Topotecan combined with cisplatin and taxol would be effective even if single topotecan has failed. Careful evaluation before treatment is indicated.