A CRITICAL REVIEW OF CHEMOTHERAPY IN THE TREATMENT OF OVARIAN CARCINOMA

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Abstract
The reports in the literature on 320 patients and the data from the author''s clinic on 42 patients show that various alkylating agents, e.g., nitrogen mustard, triethylene melamine, triethylene thiophosphoramide, chlorambucil and cyclophosphamide have a palliative effect on some patients with advanced ovarian carcinoma not suitable for treatment with surgery and radiation. The survival time in patients who showed objective response to chemotherapy was reported to be longer than in patients who did not manifest any tumor regression. No satisfactory data are available on comparative effectiveness of alkylating agents for patients with ovarian cancer. Of the patients reported in the literature, 44% (141 out of 320) showed some objective response. Clinically significant tumor regression for at least 3 months was observed in 23% of patients treated in author''s clinic, where experience has been mostly with triethylene thiophosphoramide. The duration of the response has been usually less than 6 months and rarely longer than a year. A retrospective analysis of the effect of chemotherapy on the survival of 20 patients with cancer of the ovary, as compared with the effect of radiation in 45 patients, radiation and chemotherapy in 13 patients, and no treatment in 17 patients suggests the use of radiotherapy for regional metastases followed by chemotherapy with an alkylating agent for subsequent relapses as the preferred therapeutic approach at present.