Cis-platin in combination with low dose adriamycin and cyclophosphamide in advanced ovarian carcinoma

Between February 1979 and August 1981 20 patients with advanced ovarian carcinoma have been treated according to a mitigated PAC-V protocol: cis-platin 20 mg/m2 D1-5, adriamycin 35 mg/m2 D1 and cyclophosphamide 400 mg/m2 D1, and cyclophosphamide 400 mg/m2 b 7, q 28 days. Sixteen patients were evaluable with objective, measurable tumour-parameters. Minimal follow-up time was 21/2 years. Overall response rate was 50% (8/16) with complete response in 12.5% (2/16). Median duration of complete response was 40+ months, of partial response this was 16+ months. Two year survival rate was 9/16. Patients who had a complete debulking prior to PAC-V therapy or had not been treated before responded best (5/6 and 6/7 respectively). Thirteen patients indicated experiencing subjective improvement in their condition. Haematological, renal or neurological toxicity never caused threatening problems. In conclusion, a chemotherapy regimen containing a mitigated dose of adriamycin and cyclophosphamide next to full dose cis-platin yielded good tumour and patient response without severe toxicity.