RESUMEN
Pegylated liposomal doxorubicin (PLD, Caelyx) is an emerging option for patients with recurrent ovarian carcinoma. Several phase II studies showed promising activity of PLD in recurrent ovarian cancer patients with response rate ranging from 16 to 25%. A phase III randomized trial compared PLD 50 mg/m2 day 1 every 4 weeks with Topotecan 1.5 mg/m2 daily for 5 days q 21 in recurrent ovarian cancer patients. No differences in progression free survival and overall survival were documented between treatment arms in the general population but a survival advantage was reported for platinum-sensitive subset. Our experience with PLD in the treatment of ovarian cancer is reported in this review article. Pegylated liposomal doxorubicin is effective as a second line treatment in ovarian cancer patients; comparative data are needed to establish its role in first line therapy.
Asunto(s)
Antibióticos Antineoplásicos/uso terapéutico , Carcinoma/tratamiento farmacológico , Doxorrubicina/uso terapéutico , Neoplasias Ováricas/tratamiento farmacológico , Disponibilidad Biológica , Carcinoma/mortalidad , Carcinoma/patología , Ensayos Clínicos Fase II como Asunto , Ensayos Clínicos Fase III como Asunto , Relación Dosis-Respuesta a Droga , Doxorrubicina/efectos adversos , Esquema de Medicación , Femenino , Humanos , Liposomas , Dosis Máxima Tolerada , Neoplasias Ováricas/mortalidad , Neoplasias Ováricas/patología , Pronóstico , Ensayos Clínicos Controlados Aleatorios como Asunto , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
OBJECTIVES: The aim of our study was to test the effect of a more viscous compound than existent hyaluronic acid formulation in helping to restore a defective glycosaminoglycan layer, and therefore in improving Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) symptoms when administered intravesically in IC/PBS patients. METHODS: A total of 23 female patients completed the study. Patients received endovesical administration of hyaluronic acid and chondroitin sulfate in normal saline, 40 ml, weekly for 12 weeks and then bi-weekly for 6 months, if there was initial response. RESULTS: After 12 weeks treatment both Interstitial Cystitis Symptom and Problem Index (ICSI/ICPI), pelvic pain and Urgency/Frequency Symptom Scale (PUF) showed a mean significant improvement, which was maintained thereafter. The average number of voidings and mean voiding volumes revealed significant improvement after the 12 weeks' treatment period, with a significant reduction and increase, respectively. Mean voiding volume increased from 143 ml to 191, which apparently was not reflected in a corresponding reduction of number of daily voids (from 15,5 to 14). VAS values decreased from 5,4 to 3,6 (pain) and from 6,0 to 3,5 (urgency) after the treatment cycle, showing a significant improvement. CONCLUSIONS: In our preliminary experience, the administration of intravesical hyaluronic acid plus chondroitine sulphate appears to be a safe and efficacious method of treatment in IC/PBS.