Alternating combination chemotherapy for stages III and IV ovarian carcinoma.

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Abstract
Thirty-nine previously untreated patients with stages III and IV ovarian carcinoma were treated with debulking surgery, followed by alternating combination chemotherapy with cisplatin, adriamycin and cyclophosphamide (PAC); and hexamethylmelamine, cyclophosphamide, methotrexate and 5-fluorouracil (HexaCAF). Of 19 patients with measureable disease at the onset of therapy, 10 (53%) had at least a partial response to chemotherapy. Seven (18% of total) patients were found to be pathologically free of disease of 2nd-look surgery, but 4 patients relapsed 19-31 mo. after initiating therapy. The median progression-free survival period of all 39 patients entered into the study is 12 mo.; the median crude survival is 21 mo. The PAC/HexaCAF alternating combination chemotherapy regimen may be administered with moderate toxicity, but the treatment results are not superior to those reported for PAC or HexaCAF alone in advanced ovarian carcinoma.