Ovarian cancer recurrent chemotherapy

Not every solid lesion in a postoperative patient means ovarian cancer recurrence. The combination of CA-125 and a baseline imaging study usually aids in the differential diagnosis. Postoperative hematomas, adhesions between bowel loops, or locahzed trapped fluid may mimic recurrent disease. Benign forms of diffuse peritoneal thickening such as a result of postoperative inflammatory complications or bacterial peritonitis cannot be differentiated from peritonitis carcinomatosa. Furthermore, chemical peritonitis following intraperitoneal chemotherapy also results in diffuse peritoneal thickening [32]. 

Single-agent chemotherapy is standard practice for recurrent platinum-resistant ovarian cancer. 

TABLE 91-3. Summary of Chemotherapy Agents Used for Second-Line Treatment of Progressive and Recurrent Platinum-Resistant Ovarian Cancer... 

Provide appropriate patient education on respective chemotherapy agents that will be given for treatment of recurrent ovarian cancer. 

Breidenbach M, Rein DT, Schondorf T, Schmidt T, Konig E, Valter M, Kurbacher CM. Hematological side-effect profiles of individualized chemotherapy regimen for recurrent ovarian cancer. Anticancer Drugs 2003 14(5) 341-6. 

The choice of retreatment with platinum-containing chemotherapy depends on the time frame in which the disease recurs. Patients with advanced ovarian cancer that experience disease recurrence following initial chemotherapy are divided into two therapeutic groups. Patients who do not respond to the initial platinum-containing chemotherapy or who have recurrence within 6 months after discon-... 

Gershenson DM, Kavanagh JJ, Copeland LJ, et al. Retreatment of patients with recurrent epithelial ovarian cancer with cisplatin-based chemotherapy. Obstet Gynecol 1989 73 798-802. 

Bevacizumab has been studied in advanced carcinoid tumors [167 ], prostate cancer [168 ], high-risk corneal transplantation [169 ], diabetic retinopathy [170 , 171, 172 ], ischemic retinal diseases [173 ], refractory choroidal neovascularization secondary to uveitis [174 ], macular edema secondary to branch retinal vein occlusion [175 ], retinal angiomatous proliferation [176% choroidal neovascularization attributable to pathological myopia [177, 178], exudative age-related macular degeneration [179 ], multifocal lymphangioendothe-liomatosis with thrombocytopenia [180" ], in combination with chemotherapy for the treatment of recurrent ovarian cancer [181 j, advanced melanoma [182 ], malignant pleural mesothelioma [183 ],... 

Sfakianos GP, Numnum TM, Halverson CB, Panjeti D, Kendrick IV JE, Straughn Jr. JM. The risk of gastrointestinal perforation and/or fistula in patients with recurrent ovarian cancer receiving bevacizumab compared to standard chemotherapy a retrospective cohort study. Gynecol Oncol 2009 114 (3) 424-6. 

To exemplify the benefit of isolated perfusion techniques our group compared pharmacokinetic data achieved by high-dose intravenous chemotherapy versus isolated abdominal perfusion using a stop-flow perfusion technique. Details of the techniques of this form of application are given later in this chapter. This special technique has shown promising efficacy in patients with heavily pre-treated, recurrent peritoneal metastatic ovarian cancer. 

Cannon TL, Lai DW, Hirsch D, Delacure M, Downey A, Kerr AR, et al. Squamous cell carcinoma of the oral cavity in nonsmoking women a new and unusual complication of chemotherapy for recurrent ovarian cancer Oncologist 2012 17(12) 1541-6. 

About 20% of cases of advanced breast cancer respond to hormone therapy and another 48% to antimetabolites such as 5-fluorouracil and cyclophosphamide (Brule et a/., 1973). But here, as in the chemotherapy of ovarian cancer, the figures refer to survival time rather than cure. Current interest centers on (a) prevention of the recurrence of postoperative breast cancer with a combination of methotrexate, fluorouracil, and cyclophosphamide (Bonadonna et al.y 1976), and (b) in the clinical trials now being conducted on this and other epitheliomas, most dreaded of all solid tumours, with adriamycin and the retinoids (see Sections 4.0 and 5.0 respectively). 

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