Multicenter Retrospective Analysis of High Dose Chemotherapy and Autologous PBSCT for Ovarian Cancer

Abstract

Background Ovarian cancer is one of the most chemotherapy sensitive solid tumors. However, the role of dose intensity in the chemotherapy of advanced epithelial ovarian cancer has remained controversial. Accordingly, the current study attempted to analyze the outcome of high dose chemotherapy and autologous peripheral blood stem cell transplantation for ovarian cancer retrospectively.

Methods Clinical data were collected retrospectively from 6 transplant centers in Korea between January 1996 and July 2008.ResultsTwenty three patients of total 6 centers were analyzed. The median age of the patients was 52 years (40-62 years). Nineteen patients (82.6%) were platinum sensitive and 4 patients were not. The conditioning regimens were reported to be ICE (ifosfamide, carboplatin, and etoposide) in 43.5 %, CTM (cyclophospamide, thiotepa, and melphalan) in 26.1 %, melphalan in 13%, other in 17.4 %. The median time to attain a neutrophil count greater than 500/mm3, following the transplantation, was 13 days (4~38), and to attain a platelet count greater than 20,000/mm3, was 13 days (4~38 days). There was primary graft failure of platelet in 3 patients. The median duration of progression free survival and overall survival were 6.3 months (95% CI, 0-19.3) and 19.7 months (95% CI, 10-29.4). The median overall survival was 25.9 months in the platinum sensitive patients and 17.4 months in the platinum resistant patients, however, there was no statistically significant difference in PFS between two groups. Poor prognostic factor for survival which retained statistical significance at multivariate level were platinum resistance (p=0.06, RR 3.99; 95% CI, 0.94-16.97) and clear cell type (p=0.015, RR 9.63; 95% CI, 1.56-59.45).

Conclusion Some subgroups (non clear cell types, platinum sensitive groups) of patients with ovarian cancer seem to have good outcomes after high dose chemotherapy with autologous stem cell transplantation, although several biases may have affected these observations.