11 juli 2012: onderaan hebben we het abstract van deze studie uit 2009: Whole-body hyperthermia (WBH) in combination with carboplatin in patients with recurrent ovarian cancer - a phase II study toegevoegd die de resultaten bevestigt van onderstaande studie uit 2004:
31 augustus 2005: Bron; Int J Clin Oncol. 2004 Apr;9(2):85-91.
Totale lichaams hyperthermie gegeven aanvullend naast op platinum gebaseerde chemokuur bij een recidief van eierstokkanker geeft echt hoopgevende resultaten, blijkt uit een kleinschalige fase II studie bij 21 eierstokkankerpatiënten met een recidief. De onderzoekers pleiten dan ook voor grotere gerandomiseerde fase III studies met zelfde aanpak. Voor alle duidelijkheid een recidief van eierstokkanker is in principe onbehandelbaar in de ogen van de reguliere oncologen, meestal veroorzaakt door chemo resistentie.
RESULTATEN: Een patiënt (4.8%) had een complete remissie, 7 patiënten (33.3%) had een gedeeltelijke remissie, stabiele ziekte werd gezien bij 10 patiënten (47.6%), en 3 (14.3%) patiënten reageerden niet op de behandeling en toonden progressie van hun ziekte. Mediane tijd tot progressie was 6,5 maanden en mediane overleving was 16,5 maanden.
CONCLUSIE: Onze resultaten bewijzen het effect van WBH = Totale lichaams hyperthermie bij patiënten met terugkerende platinum resistente eierstokkanker. de overall tolerantie van deze behandeling was goed. De prioriteit voor alle patiënten was een verbetering van de kwaliteit van leven; welke werd gezien al 3 tot 4 dagen na de start van de behandeling met WBH. Deze bemoedigende resultaten zouden moeten worden bevestigd in gerandomiseerde fase III studies. Patiënten wmet gevorderde kanker heben een erorm risico op een recidief na een primaire behandeling en de prognose voor deze patiënten blijft zwak. Primaire en verkregen resistentie van tumor cellen tegen antineoplastische medicijnen is een grote oorzaak van de gelimiteerde efectiviteit van chemotherapie. Het effect van totale lichaams hyperthermie (WBH) gecombineerd met platinum-bevattende chemotherapie in de behandeling van terugkerende eierstokkanker werd beoordeeld in deze studie.
Whole-body hyperthermia in combination with platinum-containing drugs in patients with recurrent ovarian cancer.
Douwes F, BogoviC J, Douwes O, Migeod F, Grote C.
St. George Hospital, Rosenheimer Str. 6-8, 83043, Bad Aibling, Germany. info@klinik-st-georg.de
BACKGROUND: Patients with advanced ovarian cancer have an enormous risk of relapse after primary therapy, and the prognosis for these patients remains bleak. Primary and acquired resistance of tumor cells to antineoplastic drugs is a major cause of the limited effectiveness of chemotherapy. The effect of whole-body hyperthermia (WBH) combined with platinum-containing chemotherapy in the treatment of recurrent ovarian cancer was examined in this study.
METHODS: Patients studied were those with pathologically verified epithelial ovarian cancer after operation who had had first-line chemotherapy with cisplatin or carboplatin, and relapsed. All 21 patients were treated with WBH and platinum-based chemotherapy. During the WBH, a core temperature of 41.5 degrees C-42 degrees C was attained in the rectum. We combined the WBH with 300-400 mg/dl artificial hyperglycemia. The plateau temperature was held over a period of, on average, 90 +/- 30 min, and the artificial hyperglycemia, on average, 240 +/- 30 min. WBH was repeated at the beginning of each new chemotherapy cycle.
RESULTS: One patient (4.8%) had a complete remission, 7 patients (33.3%) had a partial remission, stable disease was noted in 10 patients (47.6%), and 3 (14.3%) patients did not respond and had progressive disease. Median time to progression was 6.5 months, and median survival time, 16.5 months.
CONCLUSION: Our results validate the efficacy of WBH in the treatment of patients with recurrent platinum-resistant ovarian cancer. The overall tolerance of this treatment was good. The priority for all patients was an improvement in life quality; this was seen 3-4 days after WBH. The encouraging results should be confirmed in randomized studies.Patients with advanced ovarian cancer have an enormous risk of relapse after primary therapy, and the prognosis for these patients remains bleak. Primary and acquired resistance of tumor cells to antineoplastic drugs is a major cause of the limited effectiveness of chemotherapy. The effect of whole-body hyperthermia (WBH) combined with platinum-containing chemotherapy in the treatment of recurrent ovarian cancer was examined in this study.
PMID: 15108039 [PubMed - indexed for MEDLINE]
Whole-body hyperthermia (WBH) in combination with carboplatin in patients with recurrent ovarian cancer - a phase II study
Whole-body hyperthermia (WBH) in combination with carboplatin in patients with recurrent ovarian cancer - a phase II study.
Source
Klinik für Onkologie und Hämatologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, D-60488 Frankfurt am Main, Germany. atmaca.akin@khnw.de
Abstract
OBJECTIVE:
Despite considerable progress in the front-line treatment in patient with advanced ovarian cancer, the outcome of patients with recurrent or refractory disease is still poor. Based on promising results of a pilot study, we initiated a phase II study with WBH and carboplatin in pretreated patients with advanced ovarian cancer to investigate the toxicity and efficacy of WBH in combination with carboplatin.
METHODS:
47 patients with histologically confirmed epithelial ovarian carcinoma were enrolled in the study. Patients were pretreated with at least one palliative chemotherapy regimen. Of 47 patients 24 were classified as platinum refractory or resistant and 16 as platinum sensitive.
RESULTS:
Main toxicity was hematological with grade 3/4 anaemia, leukopenia and thrombocytopenia occurring in 49%, 49% and 65%, respectively. Cardiac complications occurred with grade 1/2 in 22 of 47 (47%) patients and with grade 3 in 1 patient (2%). In 35 patients evaluable for response, the overall response rate was 45% [CR: 4/35 (11%), PR: 12/35 (34%), NC: 9/35 (26%]. In platinum refractory and resistant patients we observed CR in 6%, PR in 24% and NC in 24%. The median overall survival and progression free survival were 61.5 weeks and 29 weeks, respectively.
CONCLUSION:
This study confirms that WBH in combination with carboplatin is an active salvage treatment option in patients with advanced ovarian cancer. However, significant hematological toxicity has to be considered and renders this regimen less suitable for palliative care setting. There is no evidence yet, that whole-body hyperthermia contributes to any clinical improvement beyond chemotherapy alone. This question can only be addressed in a randomized phase III trial.
- PMID:
- 19059635
- [PubMed - indexed for MEDLINE]
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