Meirosa Sibuea, M. Lutfi, M. Hakimi
 Department of Obstetrics and Gynecology
Faculty of Medicine Universitas Gadjah Mada Yogyakarta
ABSTRACT
Background: Introduction of Platinum and Paclitaxel has increased survival rate in advanced epithelial ovarian cancer. Several studies have been tried to establish the better combination with those anticancer drugs.
Objectives: Comparing complete response (CR) and progression-free survival (PFS) between Paclitaxel-Carboplatin and CAP as a first line treatment in advanced epithelial ovarian cancer.
Methods: This research used cohort retrospective study. Fifthy-three subjects with epithelial ovarian cancer FIGO stage III and IV were collected from Dr.Sardjito Hospital’s medical record analysis between January 2009 and December 2013, and divided into two groups according to chemotherapy regimens. Complete response and progression-free survival were determined after cytoreductive surgery and total 6 courses of chemotherapy.
Results: The frequency of complete response was similar, 61,5% in Paclitaxel Carboplatin group as compared with 63% in CAP group (RR 0,977, 95% CI 0,642-1,487, p=1,000). Kaplan-Meier curves showed no difference in progression-free survival between the groups, with median PFS was 15 months (95% CI 13,228-16,772) on Paclitaxel-Carboplatin and 14 months on CAP (95% CI 7,686-20,314) (p log-rank=0,741). Patients undergo optimal cytoreductive surgery attained more complete response (OR 8,274, 95% CI 1,775-38,559, p=0,007) and had a longer PFS than the suboptimal group (17 vs 13 months, p log-rank=0,046).
Conclusion: Paclitaxel-Carboplatin was not superior compared with CAP regimen as first line chemotherapy in advanced epithelial ovarian cancer. Further evaluation of survival, toxicity profile, and quality of life were needed to determine superiority of Paclitaxel-Carboplatin compared with CAP. Optimal cytoreductive surgery was an independent predictor for a better prognosis.
Keywords: advanced ovarian cancer, chemotherapy, Paclitaxel-Carboplatin, CAP