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open access - Egypt
Continuous Low-Dose Oral Cyclophosphamide and Methotrexate as Maintenance Therapy in Patients With Advanced Ovarian Carcinoma After Complete Clinical Response to Platinum and Paclitaxel Chemotherapy
Abstract
Purpose: The aim of this study was to evaluate efficacy and
safety of continuous, low dose of oral, metronomic chemotherapy as
maintenance therapy in patients with advanced ovarian carcinoma after
complete clinical response to platinum and paclitaxel chemotherapy.
Patients and Methods: In this nonrandomized study,
patients older than 18 years, with Eastern Cooperative Oncology Group
performance status less than 2, with advanced ovarian carcinoma after
complete clinical response to platinum and paclitaxel chemotherapy were
enrolled in 2 arms-arm A (maintenance arm), treated with continuous
low-dose oral cyclophosphamide 50 mg and methotrexate 2.5 mg, and arm B
(observation arm). Both arms were followed up for progression-free
survival and toxicity.
Results: Thirty patients were accrued in each arm from
January 2009 to December 2010 in Ain Shams University Hospitals, where
they received the treatment and followed up for disease progression and
toxicity. Patients had a median age of 53 years in maintenance arm and
52.5 years in the observational arm, respectively. Over 80% had
papillary serous adenocarcinoma, and over 40% of them had a stage IV
disease in both arms. After median follow-up of 27 months, patients
achieved median progression-free survival of 18 months in maintenance
arm (A) and 15.5 months in observational arm (B), respectively. Toxicity
profile was excellent with no grade 3 or 4 toxicity reported.
Conclusions: Current study may provide an evidence of
efficacy and tolerability of continuous low-dose oral cyclophosphamide
and methotrexate as a maintenance therapy in patients with advanced
ovarian carcinoma after complete clinical response to platinum and
paclitaxel chemotherapy.
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