Cisplatin, epirubicin and paclitaxel combination chemotherapy in previously untreated patients with advanced epithelial ovarian cancer

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THURSDAY,

treatment efficacy had been evaluated on the background of carditokography (CTG) data. Before the treatment the CTG data didn’t differ in both groups and testified about fetal hypoxia of medium degree (evaluation after H. Crebs sale - 6,6*0,70 bal. In the main group, 6,45*0,686 in the group of comparison, P
FC4.26.09 PSYCHOSOCIAL AND OBSTETRIC RISK FACTORS FOR POSTPARTUM DEPRESSION F.E1_ M.Chaaya, American University of Beirut, POBox 11-0236, Beirut, Lebanon. Objectives: In Lebanon as in many developing countries, the focus of the prenatal and delivery phase is on women’s medical and obstetrical problems and the well being of the fetus. The social and psychological needs of the pregnant women are rarely addressed. Accordingly, the aim of this study is to assess the prevalence and risk factors of postpartum depression. Study Methods: The study is a prospective investigation of 397 women delivering in hospitals in Lebanon over a period of two months. The first phase involved collecting information within 24 hours of delivery using a structured questionnaire, on predictors of postpartum depression. The women were asked to agree to a home visit for interview 2 to 3 months after delivery. In the second phase, data on postpartum depression were collected using Edinburgh Postnatal Depression Scale (EPDS) and other information on the health of the mother and the baby. Results: One in five women (217)D were found to have postpartum depression according to the EPDS. In the bivariate analyses postpartum depression was significantly related to depression during pregnancy, social support, type of delivery, fetal monitoring, episiotomy, education and health of the mother, and stressful life events. In the multivariate analysis, depression during pregnancy and chronic illness predicted significantly postpartum depression. Conclusions: Findings from this study are consistent with other studies. Obstetrical procedures and care during pregnancy are not adequately targeting the issues of post-partum depression. Implications for research and action concerning antenatal package, labor and delivery practices are raised.

FC4.27

OVARIAN CANCER: CHEMOTHERAPY ADVANCED DISEASE

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FC4.27.01 PRIMARY APPENDICEAL MALIGNANCY MIMICKING ADVANCED STAGE OVARIAN CARCINOMA: A CASE SERIES .I. McBroom, M.Parker, T. Krivak, G.S. Rose, Walter Reed Army Medical Center, 6825 16th Street NW, District of Columbia, Washington, United States, 20307-5001. Background: Primary appendiceal malignancies constitute 0.5% of all intestinal tumors. Non-carcinoid malignancies represent 15% of these and include mutinous cystadenocarcinoma (8%), colonic adenocarcinoma (4%), adenocarcinoid (2%), and other (1%). Excluding well-differentiated mutinous appendiceal tumors, only about 30 appendiceal tumors with ovarian metastasis have been reported in the literature. Cases: Three patients referred to our institution from 1994-1999 for presumed late stage ovarian cancer were found to have primary appendlceal adenocarcinoma, adenocarcinoid and mutinous cystadenocarcinoma metastatic to the ovaries at laparotomy. We describe the clinical course of these patients and review the relevant literature.

SEPTEMBER

Conclusions: It is important for the gynecologic oncologist to be aware of the clinicopathological features and surgical management of these malignancies as appendiceal tumors may be discovered during gynecologic surgery.

FC4.27.02 A DOSE FINDING STUDY OF DOCETAXEWCARBOPLATIN AS FIRST-LINE. CHEMOTHERAPY FOR EPITHELIAL OVARIAN CANCER - FINAL RESULTS R.Atkinson. P.A.Vasey, R.Coleman, M.Crawford, M.Cruickshank, P.Eggleton, D.Fleming, J.Graham, D.Parkin, J.Paul, N.S. Reed and S.B. Kaye on behalf of the Scottish Gynaecological Cancer Trials Group. This was a prospective, non-randomised, multicentre, open, dose finding study of a carbo-platin docetaxel (C-D) combination as first-line chemotherapy in FIG0 stage Ic-IV epithelial ovarian cancer. C-D was given 3-weekly for 6 planned cycles, with a 3-day prophylactic dexamethasone regimen (8 mg b.i.d.). 140 eligible patients (Pts) (median age 56 years, range 28-85) were given a total of 750 cycles of chemotherapy in 5 cohorts: Col, 32 pts, 169 cycles (C at AUC 5 + D 60mg/MZ), Co2, 22 pts, 122 cycles (5 + 75), Co3,29 pts, 156 cycles (6 + 75), Co4,27 pts, 146 cycles (7 + 75), Co5,30 pts, 157 cycles (6 + 85). 110 patients (78%) completed 6 cycles, 17 (12%) stopped due to toxicity. 104 patients (74%) had CTC grade IV neutropenia, and 5 patients (5%) had this associated with fever. Only 8 patients (5.7%) experienced grade II-III neurotoxicity (all sensory, no motor > grade 1). The MTD was reached in cohorts 4 and 5, and the Dose Limiting Toxicities were myelosuppression and diarrhoea. Overall Response Rate for all patients was 66% (49/74), CA125 response was 75% (70193). Median progression-free survival was 16.6 months (95% CI 13.3-19.1). Recommended doses are Carboplatin AUC 5 (via’l Cr EDTA) or AUC 6 (if calculated) plus docetaxel 75mg/mz. Significant myelosuppression is common but rarely associated with sepsis. A very low incidence of peripheral neuropathy was observed. A randomised trial comparing with carboplatin-paclitaxel is underway - SCOTROC.

FC4.27.03 CISPLATIN, EPIRUBICIN AND PACLITAXEL COMBINATION CHEMOTHERAPY IN PREVIOUSLY UNTREATED PATIENTS WITH ADVANCED EPITHELIAL OVARIAN CANCER. C.Papadimitriou’.D.LazarisZ.A.RodolakisZ,C.Kiamouris’, GM.Gourgoulis’, E.Galani’, E. Diakomanolisz, S.Michala? and M.A.Dimopoulos’. Department of Clinical Therapeutics 1”’Department of Obstetrics and Gynecology <>Hospital, School of Medicine, Athens University, Greece. Objectives : The combination of paclitaxel with cisplatin or carboplatin has become the preferred chemotherapy regimen in the treatment of advanced epithelial ovarian cancer (AEOC). Anthracyclines also have activity in the disease. We conducted a phase II study using the combination of cisplatin, epirubicin and paclitaxel (CEP) for the treatment of AEOC. Method: Fourty consecutive patients with optimally (n=7) or suboptimally (n=33) debulked advanced ovarian cancer (FIG0 stage III or IV) were treated with cisplatin 75 mg/mz IV, epirubicin 50 mg/mz IV and paclitaxel135 mg/mz as a 3-hour intravenous infusion on an outpatient basis, every 3 hours. Results: Among 28 women with measurable disease, 24 (86%) achieved an objective response including 19 complete and 5 partial responses. Among 18 patients who underwent re-assessment laparotomy, pathological complete remission was confirmed in 9 (50%). With a median follow up of 40 months the median overall survival has not been reached yet, whereas the median overall time to progression was 18.7 months. The median remission duration was 14 months. The treatment was well tolerated; the most common toxicity was neutropenia (WHO grade 3+4) which occurred in 30% of patients. Neuropathy (WHO grade 22) developed in only 8% of patients. Conclusion: CEP at the dose levels given is a very active well tolerated regimen in the treatment of AEOC.

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