Outcome of the ovarian epithelial Cancer stage I-II treated with cyclophosphamide plus cisplatinum or carboplatin.

The retrospective study outcome of the ovarian epithelial cancer stage I-II treated in Obstetrics and Gynaecological Department, Siriraj Hospital during June 1989 – June 1997, received postoperative chemotherapy cyclophosphamide plus cisplatinum (CP) or cyclophosphamide plus carboplatin (C-CP). Stage I disease of unfavourable prognosis 66 cases treated with CP and 25 cases of C-CP, achieved the 5-years disease free survival 82% and 86% respectively (P>0.05). Stage II disease of CP group, 21 cases and C-CP group, 7 cases achieved the 5-years disease-free survival 80% and 82% respectively (P>0.05). The toxicities of chemotreatment were manageble.

Establishment of OVS1 and OVS2 monoclonal antibodies recognizing human ovarian mucinous cystadenocarcinoma.

Two newly established murine monoclonal antibodies (MAbs), OVS1 and OVS2, to human ovarian mucinous cystadenocarcinoma were further characterized for diagnostic efficacy. The specific SA-1 antigen, purified from the tumor extract was identified as a glycoprotein of 29 kDa. A double determinant biotinstreptavidin alkaline phosphatase immunoassay system, containing OVS1 and OVS2 MAbs was used to determine the SA-1 levels in serum. The OVS1 MAb was used as a first antibody because of its high specificity of 96% while OVS2 MAb, with a lower specificity of 8% but greater sensitivity of 78%, was chosen as a second antibody. Matched sera of 64 healthy controls and 90 patients with definite diagnoses of 25 benign diseases, 14 nonovarian cancer and 51 ovarian cancer, were simultaneously measured together with CA 125 values. At cut-off levels of 220 and 360 units/ml, the SA-1 test showed 63% and 43% positive rates respectively in all types of ovarian cancer, compared to 65% and 57% positive rates for CA 125 at cut-off levels of 35 and 60 units/ml, respectively. Sensitivity for SA-1 at 220 units/ml cut-off level in mucinous ovarian cancer was 75% and increased significantly to 85% when the test was combined with CA 125 at 35 units/ml cut-off level. Furthermore, The combination of both tests significantly increased the positive rates to 86% in all types of early stage ovarian cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Immuno-histological characterization of OVS1 and OVS2 monoclonal antibodies recognizing human ovarian mucinous cystadenocarcinoma.

OVS1 and OVS2 monoclonal antibodies (MAbs) were established by fusing murine myeloma cell line NS1/1-Ag4-1 with mouse spleen cells immunized with fresh human ovarian mucinous-cystadenocarcinoma tissue. The selection of the MAbs was assayed by an immuno-histological (streptavidin-biotin) staining of the specific antigen antibody reaction localized on frozen sections of the same tumor. Other paraffin sections and established cell lines were also screened by immuno-histological staining in order to characterize the specificity and sensitivity of these two MAbs. OVS1 MAb showed 96% specificity and 67% sensitivity to mucinous cystadenocarcinoma with no cross reactions to normal tissue, benign tissue, other cancers, or any established cell lines. OVS2 MAb revealed only 8% specificity but 78% sensitivity to mucinous cystadenocarcinoma, however, a cross reaction to some normal and benign tissues or other cancers was shown. The data suggested that OVS1 and OVS2 MAbs could be used in combination to detect ovarian mucinous cystadenocarcinoma.

Cis-platinum and mitomycin-C in treatment of recurrent, metastatic, or residual uterine cervical cancer post radiation.

Fifteen patients with recurrent, metastatic, or residual cervical cancer post radiotherapy were treated by combined cis-platinum 40 mg/m2 IV and mitomycin-C 30 mg/m2 IV in day 1, repeated every 4 weeks for 3-5 cycles. The maintained therapy was performed by mitomycin-C 2 mg/day orally for 7 days, every 4 weeks for 6 cycles. Six of 15 patients (40%) showed complete remission and are alive without disease after a follow-up period of 5-41 months; 3 patients (20%) with partial remission are alive with disease after a follow-up period of 8-12.5 months; 6 patients (40%) with no remission expired with a survival time of 3-6 months. Severe anemia and leukopenia (grade 3-4) were seen in 26.66 per cent. Thrombocytopenia grade 4 was seen in 13.33 per cent of cases. Nausea and vomiting occurred in almost all patients. There were no problems with hepatotoxicity, nephrotoxicity, or ototoxicity.

Conservation surgery in borderline and malignant ovarian tumours.

Thirty four patients with borderline and frankly malignant ovarian tumours treated primarily with conservative surgeries, were studied. There were 8 cases of borderline tumours and 26 cases of frank malignancy, with 19 cases of epithelial cancers and 6 cases of malignant germ cell tumours. All the conservative surgical procedure were not adequate due to unrecognition of the malignant lesions. Postoperative chemotherapy was inevitably necessary in all. There were two recurrences in this series, one clear cell adeno-carcinoma who expired with disease and one immature teratoma who still survived after complete surgery and successful chemotherapy. The outcome in this study reassures that adequate conservative surgery in a woman with a unilateral borderline malignancy or malignant ovarian tumours can perform further childbearing, however a close follow up must be possible.

A prophylactic supplementation of iron and folate in pregnancy.

The supplementation of iron and folic acid were studied in 567 pregnant women with 18 and 26 weeks of gestation. Sixty mg and 180 mg of iron were given daily to pregnant women of group I and group II respectively while 180 mg of iron and 5 mg folic acid were given to group III. The Hb values increased significantly in group II and III after supplementation for 1 1/2 months, however if supplementation was extended for 3 months, highly significant increase in Hb levels were observed in all these groups. These findings indicated that in supplementation for a shorter period, i.e. 1 1/2 months at least 180 mg of iron was needed, and only 60 mg of iron was sufficient to increase Hb levels for a supplementation of 3 months. Vitamin B12 deficiency was not detected in pregnant women both before and after supplementation with iron and iron plus folate for 3 months. It was suggested therefore that perhaps it was not necessary to supplement vitamin B12 to Thai pregnant women. In this study 15% of pregnant women had low serum folate with normal red cell folate level, and a greater number of women with low serum folate concentrations were observed after supplementation with iron alone for 3 months. However, increased serum folate and red cell folate levels after supplementation with 5 mg folic acid indicated that some pregnant women needed folate supplementation in preventing folic acid deficiency during pregnancy.