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      • Treatment Outcomes of Gemcitabine in Refractory or Recurrent Epithelial Ovarian Cancer Patients

        Chanpanitkitchot, Saranya,Tangjitgamol, Siriwan,Khunnarong, Jakkapan,Thavaramara, Thaowalai,Pataradool, Kamol,Srijaipracharoen, Sunamchok Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.13

        Background: To study the response rate (RR), progression-free survival (PFS) and toxicity profiles of recurrent epithelial ovarian cancer (EOC) patients treated with gemcitabine. Materials and Methods: Recurrent EOC patients who were treated with gemcitabine between January 2000 and December 2013 at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital were identified and medical records were reviewed. Clinico-pathological features including data of gemcitabine treatment, response and toxicity were collected. Results: We identified 43 EOC patients who had gemcitabine treatment. All except one patient who did not receive any adjuvant treatment, had received platinum-based chemotherapy. Among these 42 patients, 31.0% had refractory cancer to first-line chemotherapy while 69.0% had recurrence with 48.8% being platinum-sensitive. The total cycles of gemcitabine used were 203 (median 4, range 2-9 cycles). Overall RR was 11.6%: 19% in platinum-sensitive vs 4.5% in platinum-resistant groups (p=0.158) and 42.9% in the patients having gemcitabine together with platinum vs 5.6% using gemcitabine alone (P=0.024). Median PFS was 3.6 months (95% confidence interval [CI], 2.73-4.49 months): 8.1 months (95% CI, 2.73-4.49 months) in combination regimen vs 3.2 months (95% CI, 2.01-4.42 months) in single regimen (p=0.077) and 8.1 months (95% CI, 4.73-11.48 months) with the gemcitabine combination vs 2.7 months (95% CI, 1.98-3.38 months) by single gemcitabine in platinum sensitive patients (P=0.007). Common toxicities were hematologic which were well tolerated and manageable. Conclusions: Gemcitabine has modest activity in pre-treated EOC. A combination regimen had higher activity than single agent in platinum sensitive patients with a significant improvement in RR and PFS.

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        Management of inoperable endometrial cancer

        Supakorn Pitakkarnkul,Saranya Chanpanitkitchot,Siriwan Tangjitgamol 대한산부인과학회 2022 Obstetrics & Gynecology Science Vol.65 No.4

        영어 Some endometrial cancer (EMC) patients are not good candidates for primary surgery. The three major types oftreatment for inoperable EMC are radiation therapy, chemotherapy, or their combination as neoadjuvant treatmentbefore surgery. Radiation therapy alone (of different modes) has been used as the sole definitive therapeuticmodality, particularly for early-stage disease that is limited to the uterine body and cervix with or without parametrialinvasion. The most common treatment modality is neoadjuvant treatment before surgery. Postoperative adjuvanttreatment is also occasionally used, depending mainly on the sites of the disease and the results of surgery. Data onneoadjuvant hormonal or radiation therapy are limited, with studies focusing on laboratory outcomes or havingonly a small number of patients. Most neoadjuvant treatments before surgery involved chemotherapy and fewercombined chemoradiotherapy. Surgery was generally performed, particularly in patients who had shown responses orat least stable disease to neoadjuvant treatment. Perioperative outcomes after neoadjuvant treatment were superiorto those after primary surgery, whereas survival data were still inconsistent. Features that had or tended to have afavorable prognosis were younger age, early-stage disease, response to neoadjuvant treatment, low preoperativecancer antigen-125 level, and optimal surgery. Among different modalities of neoadjuvant treatment, which hasbecome a frequent mode of treatment, neoadjuvant chemotherapy was more common than radiation therapy aloneor chemoradiation.

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