Four cycles of paclitaxel and carboplatin as adjuvant treatment in early-stage ovarian cancer: a six-year experience of the Hellenic Cooperative Oncology Group

Patients with stages Ia or Ib, Grade 2 or 3 and Ic to IIb (any grade) were included. Patients were treated with 4 cycles of Paclitaxel 175 mg/m2 and Carboplatin [area under the curve (AUC) 6 (Calvert Formula)] every 3 weeks.Sixty-nine patients with no residual disease following cytoreductive surgery and minimal or modified surgical staging were included in this analysis. Grade 3 or 4 neutropenia occured in 29.9% of patients, while neutropenic fever was reported in 4.5%. Neurotoxicity (all Grade 1 or 2) was reported in 50% of cases. Median follow-up was 62 months. 5-year overall survival (OS) and relapse-free survival (RFS) were: 87% (95% confidence intervals [CI]: 78–96) and 79% (95% CI: 69–89), respectively. Significantly fewer patients with stages Ic-IIb and tumor grade 2 or 3 achieved a 5-year RFS than patients with only one of these two factors (73% vs 92%, p = 0.03).Paclitaxel/Carboplatin chemotherapy is a safe and effective adjuvant treatment in early-stage ovarian carcinoma. Patients with stages Ic-IIb and tumor grade 2 or 3 may benefit from more extensive treatment.Ovarian cancer is a common malignancy. In most cases the disease is diagnosed at an advanced stage. Nevertheless, about 30% of patients present with early-stage disease, i.e. confined to the pelvis without spread outside the gynaecological organs (FIGO stages I and II). Surgery alone can cure a significant percentage of these patients. Nevertheless, there is a 10–50% recurrence rate, depending on stage, differentiation and histological type [1-3]. Therefore, research has been focused in developing adjuvant treatment for patients in high-risk of relapse. Historically, radiotherapy, either as external beam abdominopelvic irradiation or as intraperitoneal (i.p.) 32P, was the first modality to be tested in early ovarian cancer. Although radiotherapy is effective in ovarian cancer, its use in this setting was not supported by the results of phase II and III studies [1,4-6], while its toxicity, especial