Chemotherapy in Patients with Recurrent or Refractory Epithelial Ovarian Cancer
Darawadee Satthapong MD*, Siriwan Tangjitgamol MD*, Sumonmal Manusirivithaya MD*, Kamol Pataradool MD*
Affiliation : * Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital
Objectives : To evaluate the response rates, progression-free survival, and overall survival of patients with
epithelial ovarian carcinoma who were treated with chemotherapy after being resistant to or had recurrence
after first-line chemotherapy.
Materials and Methods : Clinical and pathological data of all patients with epithelial ovarian carcinoma who
received chemotherapy in the second-setting at the Department of Obstetrics and Gynecology, Bangkok
Metropolitan Administration Medical College and Vajira Hospital from January 1994 to December 2005
were reviewed.
Results : During the study period, 61 ovarian carcinoma patients met the inclusion criteria. All patients had
primary surgery, not responded to or had recurrence after first-line chemotherapy, and received subsequent
chemotherapy. Thirty-seven cases (60.7%) were considered as platinum-resistant and 24 cases as platinum-
sensitive (39.3%). The overall response rate (RR) to subsequent chemotherapy was 23.0% (14 patients):
complete response 18.0% (11 patients) and partial response 5.0% (three patients). Stable disease was achieved
as the best response in 11 patients (18.0%). Thirty-six patients (59.0%) experienced disease progression.
Median progression-free survival (PFS) of all 61 patients was 5.7 months (95%CI, 4.7-6.7 months) while
median overall survival (OS) was 18.3 months (95%CI, 2.7-34.0 months). Some prognostic factors were
studied and found that patients with platinum-sensitive had a better response rate, longer PFS and OS than
those with platinum-resistant diseases.
Conclusion : Response rate of ovarian carcinoma to subsequent chemotherapy for resistant or recurrent
diseases was modest. Median PFS and OS of the patients were less than and slightly longer than a year
respectively. The patients who had platinum-sensitive diseases had a better prognosis in terms of RR, PFS, and
OS than those with platinum-resistant disease.
Keywords : Epithelial ovarian carcinoma, Chemotherapy in the second-setting, Response rate
