The effect from Paclitaxel/Carboplatin regimen to advanced ovarian carcinoma

Abstract

Introduction: Ovarian cancer is the leading cause of death in developed countries and fifth most common cause of mortality in female population. Due to non specific symptoms, compression of bladder and/or rectum it is usually diagnosed in later stages. Approximately 70% are initially diagnosed in stage III with ascites. Treatment outcome is related with the stage. Clinical exam, abdominal ultrasound, CT scans and laboratory (including marker Ca125) are reguired for initial diagnosis. MR may be useful prior operation. Methods: Surgery should be the first treatment option. The aim of surgery is to achieve optimal debulking, at the same time providing tissues for histopathology analysis. Further treatment depend on staging, usually chemotherapy of carboplatin-paclitaxel. The number of cycles administered depends on estimated risk of recurrence. Results: This pattern can be modified to the individual characteristics of certain patients at the presentation. Patient aged 28, referred to University Clinic of Radiotherapy and Oncology in decreased performance status (ECOG1) for chemotherapy treatment with advanced ovarian carcinoma. Explorative laparotomy with multiple biopsies from otherwise, technically inoperable tumor was performed. HP diagnosis revealed ovarian cystadenocarcinoma. Initial high value of Ca125 marker (over 1000 U/ml), with other laboratory findings in referent ranges, allowed the use of chemotherapy with carboplatin-paclitaxel regimen. Pre-treatment CT (Jan 2017) showed bulky abdominal and pelvic tumour mass with enlarged lymph nodes. Her performance status improved shortly after the start of chemotherapy. Ca125 was reassessed after two cycles and it’s value depleted by half (Ca125=473 U/ml), thus suggesting good response. The level of Ca125 entered normal range values after the fourth cycle of chemotherapy. After the administration of planned six cycles of chemotherapy she was in good performance status, without any symptoms or complains. CT scan from (May 2017) revealed complete response, without radiological disease. Subseguent surgery (Jun 2017) was carried out and she had confirmed complete response according to histopathology analysis. First follow up, three months after the treatment (Sept 2017) consisted of clinical exam, abdominal ultrasound and measurement of Ca125 showed no evidence of disease. Conclusion: This is one more confirmation for the “golden standard” of carboplatin-paclitaxel regimen in treatment of ovarian carcinoma.