الفهرس 
Molecular BiologyOnly 14 pages are availabe for public view
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Abstract
O
varian cancer remains the leading cause of gynecologic cancer death. World wide, there are 166000 cases and 101000 deaths from ovarian cancer each year. Overall, ovarian cancer accounts for 5% of all cancer deaths, and 4% of all cancer diagnosis in women. Most ovarian cancers (90%) are epithelial in origin, and often, have already progressed to an advanced stage at the time of diagnosis (Jemal et al., 2008).
Epithelial ovarian cancer is the eighth most common cancer in women in the United States; it is the fourth leading cause of death from cancer, with 21,650 cases per year diagnosed and 15,520 deaths predicted in 2008. The goal of treatment of recurrent ovarian cancer is palliative, as there is no realistic chance of curing patients whose disease has recurred. In light of this observation, quality of life, prolongation of survival, and control of symptoms related to the cancer are the primary goals of treatment of recurrent disease. Median survival after diagnosis of recurrence is 2 years, but survival can range from months to longer than a decade. The majority of patients with disease recurrence will receive a series of different regimens over the course of their disease (Jemal et al., 2008).
More than two thirds of patients with epithelial ovarian carcinoma present with advanced (stage III or IV) disease. The majority will respond well to initial treatment, but up to 80% of patients with a diagnosis of stage III or IV ovarian carcinoma will experience a recurrence of their disease. Those patients with a treatment-free interval between 5 to 12 months following initial therapy have a response rate of 25% to 30% compared with almost 60% response rate for those with treatment-free interval longer than 24 months. For patients with platinum-resistant disease, numerous single agents have shown some activity, including paclitaxel (if not part of the original regimen), etoposide, liposomal doxorubicin, Gemcitabine and topotecan. Response rates range between 20% and 35% (Morgan et al., 2004).
This study is a randomized phase II trial including 25 patients with recurrent ovarian tumor of (epithelial type) who attend to Ain Shams University Hospitals during period January 2007 to June 2009.
The 25 patients were eligible, had detailed medical history, full physical examination and radiological examination, with a pretreatment full laboratory investigation.
All patients received Gemcitabine plus Platinum drug (Cisplatin or Carboplatin) in a dose of Gemcitabine 1000mg/m2 on day 1&8 plus Cisplatin in a dose of 60mg/m2 on day 1 or Carboplatin area under curve (AUC) 4mg/ml/min on day 1. Cycles were repeated every 21 days for six cycles in the absence of progressive disease or unacceptable toxicity. The primary objective of this study was (PFS) progression free survival. Secondary endpoints include, response rate.
Hematologic toxicity was moderate and the non-hematologic toxicity was insignificant and accepted by the patients.
Four patients achieved a complete response and eight patients showed partial responses resulting in an overall response rate of 48%. Ten patients had a stable disease, while three patients had a progressive disease.
The median survival time for all patients were 22 months, with one year survival of 87% and two year survival of 44%.