THERAPY OF OVARIAN CANCER WITH PACLITAXEL Our Results

Abstract

Cilj istraživanja. Standardna kemoterapija u bolesnica s lokalno uznapredovalim rakom jajnika stadija II do IVa je kombinacija paklitaksela s cisplatinom/karboplatinom. Više od 75% bolesnica javlja se upravo u tim stadijima bolesti. Početkom 90-tih godina prošlog stoljeća ova kombinacija lijekova koristila se u recidivima nakon incijalne kemo-terapije s cisplatinom/karboplatinom, u kombinaciji s ciklofosfamidom i/ili adriamicinom, da bi se nakon zadovoljavajućih rezultata nakon 1995. godine počela koristiti i u »prvoj« liniji liječenja. Metode. U Zavodu za ginekološku onkologiju Klinike za ženske bolesti i porode KBC-a Zagreb započeli smo primjenom paklitaksela 1994. godine. Od 1994.–1996. godine davali smo ga isključivo u slučaju recidiva da bismo 1996. godine prvi puta započeli liječenje spomenutom kombi-nacijom kao prvom linijom. Od 1994. do 2002. godine ukupno je liječeno 65 bolesnica; paklitaksel je ušao na listu lijekova Hrvatskog Zavoda za zdravstveno osiguranje (HZZO) za recidiv bolesti 1997. godine, a tek 1998. godine za prvu liniju uz posebne zamolbe HZZO-u. Svaka je bolesnica primila između 4–10 ciklusa kemoterapije te je ukupno primijenjeno preko 650 ciklusa kemoterapije. Rezultati. Tijekom primjene ni u jedne bolesnice nismo imali smrtni ishod, a samo kod dvije (3%) ozbiljnije alergijske reakcije koje su uspješno zbrinute, pa je nastavljeno s kemoterapijom. Zaključak. Na temelju našega iskustva možemo reći da je paklitaksel u kombinaciji s cisplatinom/karboplatinom vrlo učinkovit citostatik te da se naši rezultati liječenja ne razlikuju od rezultata objavljenih u svjetskoj literaturi.The aim of investigation. Standard chemotherapy in patients with locally advanced ovarian cancer stage II to stage IV is the combination of paclitaxel with cisplatin/carboplatin. More than 75% of patients are diagnosed at these stage of disease. At the begining of the 90’s of last century this combination of agents was used in recurrencies after initial chemotherapy with cisplatin/carboplatin with cyclophosphamide and/or adriamycin and has, proving to have satisfactory results, since 1995 been used in the first-line therapy. Methods. At Gynecologic Cancer Center, University Hospital Zagreb the use of paclitaxel started in 1994; from 1994 to 1996 paclitaxel was exclusively used for patients with recurrent disease. The use of paclitaxel plus cisplatin/carboplatin combination began as the first-line therapy in 1996. From 1994 to 2002 a total of 65 patients were treated with this combination. In 1997 paclitaxel was listed by the Croatian Health Insurance Agency (HZZO) as therapy for recurrent disease; in 1998 was the special request to HZZO for the first-line therapy and in 2002 separate funds were allocated for the treatment of patients with ovarian cancer stage II to IV with paclitaxel. From 1994 to 2001 paclitaxel was used in 23 patients, of which 5 in the first-line therapy and 18 after recurrencies as second-line therapy. In 2002, 42 patients were treated with paclitaxel – 32 in the first-line and 10 in the second-line therapy. Considering the fact that each patient was treated with between 4 to 10 cycles of chemoterapy, it has amounted to a total of more than 650 cycles of chemotherapy. Results. No treatment had a death outcome, only two patients (3%) experienced a serious allergic reaction but were successfully managed and chemotherapy was continued. Conclusion. Our experience confirms that paclitaxel in combination with cisplatin/carboplatin is a very effective drug and our results of chemotherapy do not differ from the results published in the world literature