Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
P. S. Dattatreya
Scientific Tracks Abstracts: J Pediatr Therapeut
The WHO classification of ovarian tumors has four broad sub groups: Epithelial tumors, Sex cord-stromal tumors, Germ cell tumors, and Gonadoblastoma. The surgical management for dyspgerminomas and non�dysgerminomas is fertility sparing surgery (FPS). Chemotherapy with protocols like PEB is advocated for germ cell tumors > stage IA. With the PEB protocol for 3 � 4 cycles, 80% regain normal menstrual function with several documented pregnancies. Various phase 3 trials in advanced EOCs (Epithelial Ovarian Cancers) have established Paclitaxel + Carboplatin every 3 weeks for 6 cycles as the standard of care (2004 GCIG recommnended standard) with a median PFS of 15.4 � 16.4 months and 30�35% 5 year overal survival (OS). Substitution of Paclitaxel (with Docetaxel or PLD), maintenace Paclitaxel for 1 year, Consolidation chemotherapy with Topotecan, adding a 3rd drug to Paclitaxel and Carboplatin have all shown no advantage. Intraperitoneal chemotherapy and dose�dense chemotheray have shown an OS benefit at the expense of higher grade 3 and grade 4 side effects. The GOG 218 trial incorporating Avastin for 15 months and the ICON7 trial incorporating Avastin for 12 months showed a statically significant improvement in the PFS when compared to Paclitaxel + Carboplatin. In Platinum sensitive recurrent EOC, adding Avastin to Gemcitabine + Carboplatin (as in the OCEANS trial) showed a significant PFS benefit. In platinum resistant recurrent EOC, adding Avastin to various chemotherapy options (Investigator�s choice) showed a significant PFS benefit. Avastin, therefore, seems to be the ideal partner of choice with chemotherapy in advanced EOC as first-line and in platinum-sensitive and platinum-resistant recurrent ovarian cancer.
P. Satya Dattatreya obtained his DM training in medical oncology from the Gujarat Cancer and Research Institute, Ahmedabad and his DNB in medical oncology from the NBE, New Delhi. He is presently working as a senior consultant in medical oncology at the Omega hospitals, Banjara hills, Hyderabad.