OSAMURA Yoshiyuki Tokai Univ.School of Med.Professor, 医学部, 教授 (10100992)
MURAMATSU Toshinari Tokai Univ.School of Med.Instructor, 医学部, 助手 (90266437)
MIYAMOTO Tsuyosi Tokai Univ.School of Med.Instructor, 医学部, 助手 (60209947)
MURAKAMI Masaru Tokai Univ.School of Med.Assistant Professor, 医学部, 講師 (00190893)
|Budget Amount *help
¥2,300,000 (Direct Cost : ¥2,300,000)
Fiscal Year 1998 : ¥600,000 (Direct Cost : ¥600,000)
Fiscal Year 1997 : ¥800,000 (Direct Cost : ¥800,000)
Fiscal Year 1996 : ¥900,000 (Direct Cost : ¥900,000)
BACKGROUND.Next results were obtained by high dose chemotherapy(HDC) with autologous bone marrow transplantation in advanced and refractory ovarian cancer.
PATIENTS AND METHODS.After maximum debulking surgery of the 105 epithelial ovarian cancer patients, HDC with stem cell support was given composed of cyclophosphamide 1600-2400 mg/m^2 adriamycin 80-100 mg/m^2+ cisplatin 100-150 mg/m^2(n=58), or carboplatin 900-1500 mg/m^2+ cyclophosphamide 3000 mg/m^2. ABMT or PBSCT were performed 48 hours or 72 hours after HDC, respectively.
RESULTS.Five- and 8-years overall survivals(OS) by FIGO stage were I c(n13) : 92.3%.92.3%, II (n=12) : 73.3%.73.3%, LII (n=46) : 58.1%.48.8%, lV(n=19) : 33.7%. 33.7% , relapsedlrefractory(n=15) : 37.5%.37.5% , and disease free survival(DFS) were I c : 92.3%.92.3%, II : 73.3%.73.3%, III : 35.7%.31.7%, IV : 22.6%.22.6% , relapsedlrefractory : 31.0%.31.0%. In 65 stage 1III/V patients, 5-year OS accordinng to the residual tumor size before performing HDC were 0-0.5 cm (n=35) : 74.3%, 0.6-2 cm(n=13) : 30.8%, >2 cm(n=17) : 22.6%. Best results of long long term survival were obtained in 35 patients with small volume residual disease(0-0.5cm). Histologically, patients with mucinous and clear cell adenocarcinoma showed significantly worse long term survivals than other histologies.
FUTURE STRATEGY.For better long term survivals, we are now planning HDC with peripheral blood stem cell transplantation containg multi drugs including pacitaxel, which sensitive for epithelial ovarian cancers.