Tratamento do Câncer Avançado do Ovário. Resultados com o AVC (Adriamicina, VM-26 (Teniposide) e Ciclofosfamida)
DOI:
https://doi.org/10.32635/2176-9745.RBC.1983v29n4.3497Keywords:
Carcinoma, Ovarian Epithelial/therapy, Carcinoma, Ovarian Epithelial/drug therapy, Doxorubicin, Teniposide, CyclophosphamideAbstract
Twenty four patients with advanced carcinoma of the ovary, predominantly of the epitelial type (stage III and IV) were treated with a new association of chemoterapeutic agents — VM 26 (TENIPOSIDE), ADRIAMYCIN and CYCLOPHOSPHAMIDE - (AVC). Three courses of A VC were given as preoperative chemotherapy followed by radical hysterectomy with omentectomy and removal of all possible celomic methastasis. Six courses of AVC were administered as adjuvant chemotherapy followed by laparoscopy and second-look for eventual search of remainig residual disease. Seventy per cent of all patients showed objective response. Of those, 10% gave complete response, although 60% gave only partial response. Two patients with complete response confirmed at a second-look operation remainened asymptomatic for a 26 months follow-up period. The average maintenance of therapeutic response was 8.5 months with a survival of 13 months. All patients with controlled disease (25%) have survival for 7.6 months (average) where as those with rapidiy Progressive disease (10%) were dead at the end of 4.5 months (average). The AVe - Surgery — AVC protocol has proven useful in control and survival of advanced carcinoma of the ovary. The toxicity has been considered (to be within) folerable limits.
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References
Cancer Facts and Figures 1980. — American Cancer Society Publication, New York, 1980.
VALLE, J.C. — Aspectos clínicos do Câncer Gástrico inicial. — Medicina de Hoje, 57: 642-648, 1979.
BRUMINI, R. (Ed.) e cols. - Câncer no Brasil: dados histopatológicos = Cancer in Brazil: histopathology data 1976 — 1980. — Rio de Janeiro, Campanha Nacional de Combate ao Câncer, Ministério da Saúde, 1982.
ZUBROD, G. et alli — Appraisal of methods for the study of chemotherapy of cancer in man: Comparativa therapeutic trial of nitrogen mustard and triethylenethiophosphoramide. - Journal of Chronic Diseases, 11: 7-33, 1960. DOI: https://doi.org/10.1016/0021-9681(60)90137-5
DELCLOS, L. & QUINLAN, E.J.l. Malignant tumor of the ovary managed with postoperative megavoltage irradiation. - Radiology, 93: 659-663, 1969. DOI: https://doi.org/10.1148/93.3.659
GRIFFITHS, C.T. — Surgical resection of bulk tumor in the primary treatment of ovarian carcinoma. - Symposium on Ovarian Cancer. Natl. Cancer Ins. Mongr., 42: 101-104, 1975.
SMITH, J.P. & DAY, T.G. - Review of ovarian cancer at the University of Texas Center, M.D. Anderson Hospital and Tumor Institute. — Am. J. Obstet. Gynecolol., 135S84-993, 1979. DOI: https://doi.org/10.1016/0002-9378(79)90824-X
KAPLAN, E.L. & MEIER, P. - Nonparametric Estimation from Incompleta Observations. - Journal of the American Statistical Association, 53: 457-481, 1958. DOI: https://doi.org/10.1080/01621459.1958.10501452
Clinical Cancer Chemotherapy. — Edited by E.M. Greenspan. Raven Press, New York, 1975. Chapter 10, pgs. 207-220.
SMITH, aP. & RUTLEDGE, F. - Chemotherapy in the treatment of cancer of the ovary. — American Journal of Obstetries and Gynecology, 107: 691-701, 1970. DOI: https://doi.org/10.1016/S0002-9378(16)33987-4
SMITH, J.P.; RUTLEDGE, F.; WHARTON, J.T. – Chemotherapy of ovarian cancer. New approaches to treatment. Cancer 30: 1565, 1972. DOI: https://doi.org/10.1002/1097-0142(197212)30:6<1565::AID-CNCR2820300623>3.0.CO;2-H
BARLOW, J.J. & PIVER, M.S. - Single agent vs. combination chemotherapy in the treatment of ovarian câncer. - Obstet. Gynecol., 49609, 1977.
McGUIRE, W.P.; YOUNG, R.C. - Ovarian cancer, in Staquet MJ (ed): Randomized Trials in Cancer: A Critical Review by Sites. — New York, Raven Press, 1978, pp. 273-288.
YOUNG, R.C. et alli – Advanced ovarian adenocarcinoma: A prospective clinical trial of melphalan (L-PAM) vs. combination chemotherapy (Hexa-CAF). — N. Engl. J. Med., 299: 1261, 1978. DOI: https://doi.org/10.1056/NEJM197812072992301
EDMONSON, T.H.; Fleming, T.R.; Decker, D.G.; Malkasian, G.D. et al — Different chemotherapeutic sensivities and host factors affecting prognosis in advanced ovarian carcinoma versus minimal residual disease. — Cancer Treat. Rep., 63:241, 1979.
BRUCKNER, H.W. et all - Chemotherapy of gynecological tumors with platinum II. — J. Clin. Hematol. Oncol., 7619, 1977.
WILTSHAW, E.: Discussion in Clinical trials of cis-piatinum diammine dichioride, Krakoff, IH. — J. Clin. Hematol. Oncol., 7: 617, 1977.
GREENWALD, E.; VOGL, S.E.; KAPLAN, B.H.; WOLLNER, D. - Hexamethylmelamine (H) and diamminedichloroplatinum (D) alone or with adriamycin (A) in patients with advanced ovarian cancer resistant to alkylating agents. — Proc. Am. Assoe. Cancer Res., 19: 327, 1978.
VOLG, S.E.; BERENZWEIG, M.; KAPLAN, B.H.; MOUKHTAR, M.; BULKIN, W. - The CHAD and HAD regimens in advanced ovarian cancer: Combination chemotherapy including cyclophosphamide, hexamethylmelamine, adriamy cin and cisdichiorodiammine platinum (II). — Cancer Treat. Rep., 63: 311, 1979.
BRUCKNER, H.W. and alli - Combination chemotherapy for ovarian carcinoma with cyclophosphamide, adriamycin and cis-dichlorodiammineplatinum (III after failure of initial chemotherapy. — Cancer Treat. Rep., 62: 1021, 1978.
EHRLICH, C.E.; EINHORN, L.H.; WILLIAMS, S.D.; MORGAN, J. - Chemotherapy for stage lll-IV epithelial ovarian cancer with cisdichiorodiammine-piatinum (III), adriamycin and cyclophosphamide. A preliminary report. — Cancer Treat. Rep., 63: 281, 1979.
YOUNG, R.C.; VON HOFF, D.D.; GORMLEY, P.; MAKUCH, R.; CASSIDY, J.; HOWSER, D.; BULL, J.M. — Cis-Diamminedichloroplatinum II for the treatment of advanced ovarian cancer. — Cancer Treat. Rep., 63: 1539, 1979.
VALLE, J.C.; SARAIVA PONTES, A.A.; CARVALHO FILHO, R.; MATTOS, M.M.H. - Estudo clínico do VM-26 em associação de drogas no tratamento dos linfomas malignos, leucemias e tumores sólidos. — Rev. Bras. Câncer., 4: 47-57, 1977. DOI: https://doi.org/10.32635/2176-9745.RBC.1977v27n4.3636
STAHELIN, H. - VM-26, a new podophyllotoxin glucoside derivativa with anti L 1210 activity. — Proc. Amar. Ass. Cancer. Res., 10:86, 1969.
