Part I: chemotherapy for epithelial ovarian cancer-treatment at first diagnosis

Ovarian cancer leads to more deaths than any other gynaecological cancer in the more developed countries. During the past 30 years, survival has increased owing to improvements in diagnosis, surgery, and chemotherapy. Despite these advances, most patients will die from the disease, and the overall 5-year survival is less than 50%. Most patients with ovarian cancer need cytotoxic chemotherapy. Platinum agents (cisplatin and carboplatin) are the most important drugs to be included in first-line regimens. Randomised trials have recently confirmed the benefit of the addition of taxanes to platinum, and the standard of care has become the combination of carboplatin and paclitaxel. However, unanswered questions remain over the optimum schedule, duration, and intensity of treatment, and the benefit or otherwise of the addition of other drugs to carboplatin and paclitaxel. The roles of intraperitoneal therapy and consolidation treatment after first-line chemotherapy are as yet undefined.