Toxicity and Tolerability of Paclitaxel and Carboplatin Regime in Patients with Epithelial Ovarian Cancer at a Tertiary Care Hospital

International Journal of Medical Science

© 2018 by SSRG - IJMS Journal

Volume 5 Issue 1

Year of Publication : 2018

Authors : Praveen Jacob Ninan, Dharam Prasath and Mary James

10.14445/23939117/IJMS-V5I1P102

How to Cite?

Praveen Jacob Ninan, Dharam Prasath and Mary James, "Toxicity and Tolerability of Paclitaxel and Carboplatin Regime in Patients with Epithelial Ovarian Cancer at a Tertiary Care Hospital," SSRG International Journal of Medical Science, vol. 5,  no. 1, pp. 5-9, 2018. Crossref, https://doi.org/10.14445/23939117/IJMS-V5I1P102

Abstract:

Epithelial Ovarian cancer treatment is based on cytoreductive surgery and combination chemotherapy with taxane and platinum compounds. The present study aims to analyse the toxicity and tolerability of Paclitaxel and Carboplatin regime in EOC. This study was prospective observation study done in Govt. T.D. medical college, Alappuzha over a period of 18 months. All patients with epithelial ovarian cancer selected for first line chemotherapy with Paclitaxel and Carboplatin combination regimen irrespective of age. They were studied for toxicity pattern, tolerability of this regime, assess the performance of patients and to study the prevalence of neutropenia The Mean age of patients was 51.15 years. Most common associated medical condition was Diabetes Mellitus. The most common histopathological type in this study is serous cancer. Majority patients had ECOG performance score 1 before chemotherapy and 3 after chemotherapy. The most common non- haematological toxicity was found to be Alopecia. Most common haematological toxicity was found to be Neutropenia. In our study the toxicity profile of this regimen was well tolerated. Non- haematological toxicity like Alopecia, Vomiting, Myalgia, Nausea, Arthralgia, Fatigue, Peripheral Neuropathy, Diarrhoea, Pruritus, Oral Mucositis, Stomatitis and haematological toxicity like Neutropenia, Anaemia and Thrombocytopenia were significant clinical parameters.

Keywords:

Epithelial Ovarian Cancer, Paclitaxel, Carboplatin, Toxicity, Tolerability.

References:

[1] Colombo N, Peiretti M, Parma G, et al. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2010; 21 (5):v23–v30.
[2] Ovary Cancer. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/ovary.html
[3] Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin 2007;57:43–66
[4] .http://www.cancer.org/cancer/ovariancancer/detailedguid e/ovarian-cancer-key-statistics
[5] Murthy NS, Shalini S, Suman G, Pruthvish S, Mathew A. Changing trends in incidence of ovarian cancer—the Indian scenario. Asian Pacific Journal of Cancer Prevention. 2009; 10(6):1025–1030.
[6] Curado MP, Edwards B, Sinha HR, et al (Eds) (2007) Cancer Incidence in Five Continents Vol .IX. IARC Scientific Publication No. 160; Lyon, IARC.
[7] Gamarra-Luques CD, Goyeneche AA, Hapon MB, Telleria CM. Mifepristone prevents repopulation of ovarian cancer cells escaping cisplatin-paclitaxel therapy. BMC Cancer. 2012;12, article 200.
[8] Goodman MT, Howe HL, Tung KH, et al. Incidence of ovarian cancer by race and ethnicity in the United States, 1992–1997. Cancer. 2003;97:2676–2685
[9] Dubeau L. The cell of origin of ovarian epithelial tumors and the ovarian surface epithelium dogma: does the emperor have no clothes? Gynecol Oncol 1999;72:437– 442.
[10] Kurman, RJ. Blaustein's pathology of the female genital tract. Vol. 5th ed. New York: Springer-Verlag; 2002.
[11] Kim A, Ueda Y, Naka T, Enomoto T. Review: therapeutic strategies in epithelial ovarian cancer. Journal of Experimental & Clinical Cancer Research. 2012;31, article 14.
[12] Robert F, Ozols SCR, Thomas GM, Robboy SJ. Epithelial ovarian cancer. In: Hoskins WJ, editor. Principles and Practice of Gynecologic Oncology. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005.
[13] Hanan Shawky, Hesham Tawfik, Medhat Hewidy. Weekly dose-dense paclitaxel and carboplatin in recurrent ovarian carcinoma: A phase II trial. Journal of the Egyptian National Cancer Institute, 2014;26: 139–145.
[14] P Georgeena, Anupama Rajanbabu, DK Vijaykumar, et al. Surgical treatment pattern and outcomes in epithelial ovarian cancer patients from a cancer institute in Kerala, India. E cancer medical science. 2016; 10: 619.
[15] S.NAGAO, K. FUJIWARA, R. OHISHI, et al. Combination chemotherapy of intraperitoneal carboplatin and intravenous paclitaxel in suboptimally debulked epithelial ovarian cancer. Int J Gynecol Cancer 2008, 18, 1210–1214.
[16] Andreas du Bois, Hans-Joachim Lu¨ck, Werner Meier, Hans-Peter Adams, et al. A Randomized Clinical Trial of Cisplatin/Paclitaxel versus Carboplatin/Paclitaxel as First- Line Treatment of Ovarian Cancer. Journal of the National Cancer Institute, Vol. 95, No. 17, September 3, 2003; 1321-1330.
[17] Sharma R, Graham J, Mitchell H, Brooks A, Blagden S, Gabra H. Extended weekly dose-dense paclitaxel/carboplatin is feasible and active in heavily pre-treated platinum resistant recurrent ovarian cancer. Br J Cancer 2009; 100(5):707–12.
[18] Van der Burg ME, Vergote I, Onstenk W, Boere IA, Leunen K, van Montfort CA, et al. Long-term results of weekly paclitaxel carboplatin induction therapy: an effective and well-tolerated treatment in patients with platinum-resistant ovarian cancer. Eur J Cancer 2013;49(6):1254–63.
[19] Upasana Baruah, Debabrata Barmon, Amal Chandra, et al. Neoadjuvant chemotherapy in advanced epithelial ovarian cancer: A survival study. Indian J Med Paediatr Oncol. 2015 Jan-Mar; 36(1): 38–42.