[High-dose chemotherapy in advanced epithelial ovarian cancer]

Since more than thirty years, ovarian cancer is wellknown to be chemosensitive. However, long term results of advanced stages remain low with 5 years overall survival around 20%. That's why high-dose chemotherapy in this chemosensitive disease has to be considered. Here, authors report the french, european and american experiences in three clinical settings: first in consolidation after complete or very good partial response, second after relapse or for refractory disease, third as first line treatment to increase clinical and pathological complete responses and improve prognosis. The more promising results concern high-dose chemotherapy as consolidation setting. The preliminary results of the french multicentric randomized phase III study (high-dose versus conventional dose) gives a favorable trend for high-dose approach as consolidation. This unique trial would definitively establish the place of high-dose chemotherapy in the first line treatment of advanced epithelial ovarian cancer.