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Carboplatin with cyclophosphamide in patients with advanced ovarian cancer: an efficacy and quality-adjusted survival analysis
  1. P.H.B. WILLEMSE*,
  2. E.G.E. DE VRIES*,
  4. D. L. FONTEIN,
  5. J. G. AALDERS§ and
  1. *Departments of Medical Oncology
  2. §Gynecologic Oncology, University of Groningen
  3. Ny Smellinghe Hospital Drachten
  4. Scheper Hospital Emmen, The Netherlands
  1. Address for correspondence: P.H.B. Willemse, MD, Department of Internal Medicine, University Hospital, Oostersingel 59, 9713 EZ Groningen, The Netherlands.


The efficacy and toxicity of a combination of carboplatin and cyclophosphamide (CC) were studied in a group of 76 patients with advanced ovarian cancer. Progression-free (PFS) and overall survival were compared with a historical group of 65 patients treated with CAP-5 (cyclophosphamide, adriamycin, cisplatin). Subjective toxicity was compared by the measurement of TWiST, the Time Without Symptoms of Disease or Treatment. Of 75 evaluable patients treated with CC, 18 (24%) had a pathologically complete remission (pCR), and 31 (41%) a partial remission (PR). CC led to leukopenia grade III in 38% and grade IV in 3% of 421 treatment cycles. Thrombocytopenia grade III was seen after 7% and grade IV after 2% of cycles. Treatment delay occurred in 11.5% and dose reduction in 21% of cycles. Nephro- or neurotoxicity did not occur. After a median follow-up of 18 months, the median PFS was 24 months and the overall survival was 25 months. Median duration of TWiST was 22 versus 10 months after CAP-5 (P < 0.01). Compared with historical controls, treatment with CC is equivalent to CAP-5. It is free of nephro- and neurotoxicity, but is more myelosuppressive. Quality of life, measured by TWiST, is significantly better during CC. As a consequence of its equivalent efficacy, but lower subjective toxicity, carboplatin should replace cisplatin in treating patients with advanced ovarian cancer.

  • carboplatin
  • chemotherapy
  • cisplatin
  • ovarian cancer
  • quality of life

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