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CC BY-NC-ND 4.0 · South Asian J Cancer 2016; 05(02): 059-062
DOI: 10.4103/2278-330X.181627
METRONOMIC THERAPY IN OVARIAN CANCER : Original Article

Outcomes of advanced epithelial ovarian cancer with integration of metronomic chemotherapy: An Indian rural cancer centre experience

Avinash Pandey
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
Department of Medical Oncology, BKLWH, Dervan, Chiplun, Ratnagiri, Maharashtra
,
Desai Abhay
Department of Surgical Oncology, BKLWH, Dervan, Chiplun, Ratnagiri, Maharashtra
,
Jandyal Sunny
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Ostwal Vikas
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Patil Vijay
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Kulkarni Rajeshri
Department of Pathology, BKLWH, Dervan, Chiplun, Ratnagiri, Maharashtra
,
Patil Netaji
Department of Radiodiagnosis, BKLWH, Dervan, Chiplun, Ratnagiri, Maharashtra
,
Gupta Sudeep
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Shripad D. Banavali
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
› Author Affiliations Financial support and sponsorship: Nil.
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Abstract

Background: Paclitaxel-platinum and optimal cytoreductive surgery are the standard of care for ovarian carcinoma. Poor socioeconomic profile and therapeutic constraints in rural India poses a therapeutic challenge. Aim: To evaluate outcomes of epithelial ovarian carcinoma. Objectives: To calculate disease-free survival (DFS), overall survival (OS), and factors affecting outcomes. Materials and Methods: Data of patients diagnosed as ovarian carcinoma registered between March 2009 and March 2014 were retrieved. Demographic profile, chemotherapy and response, surgery, and disease progression were collected. Patients who underwent surgery or completed three cycles of chemotherapy were selected. Kaplan-Meir survival was used to determine disease-free and OS. Log-rank test used to evaluate factors affecting outcome. Results: Median follow-up is 26 months. 93/102 patients (91%) underwent cytoreductive surgery, of which 37 had primary cytoreduction (40%) while 56 had interval cytoreduction. 21/93 (23%), 57/93 (61%), and 15/93 (16%) patients were operated by local surgeons, surgeons of our hospital, and trained oncosurgeons, respectively. Induction paclitaxel-platinum was used in 35/63 (56%) patients while 28/63 patients (44%) received neoadjuvant metronomic chemotherapy. Median DFS and OS are 17 and 54 months respectively while 3 year OS of 66%. Median DFS of patients operated by oncosurgeons versus local surgeons were 22 months versus 15 months (P = 0.01), OS was 54 versus 26 months (P = 0.01).40/88 (45%) patients received maintenance metronomic therapy after adjuvant chemotherapy with median of 6 months (range 2-18 months). Patients receiving metronomic maintenance had better DFS, 18 months versus 15 months (P = 0.69). Conclusion: Induction therapy in ovarian carcinoma helps in selecting patients for cytoreductive surgery. Outcomes are better if operated by trained oncosurgeons. Maintenance metronomic has potential to delay disease progression.

Key words

Advanced epithelial carcinoma ovary - metronomic maintenance - metronomic neoadjuvant


Publication History

Article published online:
28 December 2020

© 2016. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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