Treatment of advanced ovarian cancer: 10 years of experience

Although the majority of the patients with advanced ovarian cancer will die of the disease, optimism is justified in view of the improved results of surgery followed by cisplatin--and carboplatin-based chemotherapy. Currently, approximately 30% of the patients reach a complete remission and a long therapy-free period with a good quality of life after treatment with 6 cycles of cyclophosphamide and cisplatin. Cisplatin-based two-, three-, and four-drug regimens probably give equal results, with respect to survival outcome, if equitoxic dosages are used. Because of its more favourable toxicity spectrum, carboplatin is likely to replace cisplatin in the near future. The group of long-term survivors includes patients with a good performance status, a well-differentiated tumour, and small tumour residuals after the initial laparotomy. Patients who relapse after a period without treatment may benefit from retreatment with cisplatin or the analogue, carboplatin, given alone or in combination with cyclophosphamide. New promising approaches are now being tested in clinical trials and may be expected to yield new ways to improve treatment results. Results of fundamental research may lead to the development of new treatment strategies in the next decade and further improve the outlook for patients with ovarian cancer.