[Consensus and new development in epithelial ovarian cancer chemotherapy in 1995]

Recent clinical trials have confirmed that cisplatinum combination has advantages for advanced ovarian cancer interns of response rate, response duration and disease-free time, but little advantage for overall survival. Although addition of doxorubicin to cisplatin-based chemotherapy is a matter of controversy between European countries and the USA, high-dose epirubicin, which is an analog of doxorubicin, has a potent response in relapsed cases after CDDP combination chemotherapy. Clinical trails of epirubicin + CPA + CDDP for advanced ovarian cancer and underway in Japan. Under standard supportive care, escalated CDDP dose may prolong median survival time, but its advantage for long-time survival is questionable. Trials of high-dose chemotherapy as front line treatment for advanced ovarian cancer supported by PBSCT/G-CSF in combination with assessment of scheduled AUC have been collected from many world-wide institutes. GOG demonstrated that intraperitoneal administration of CDDP with intravenous CPA had obvious superiority to intravenous CDDP and CPA in overall survival and adverse effect for stage III ovarian cancer, under the conditions that 70% of cases had minimum residual tumor (< 0.5 cm). We have to make sure whether this modality has the same effect on early and stage IV ovarian cancer. Taxol plus CDDP has promising benefits for median disease free survival and median survival time, so it is becoming the standard regimen for advanced ovarian cancer in USA. The delay of the clinical introduction of taxanes should be eliminated promptly in Japan.