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High-Dose Therapy for Ovarian Carcinoma

Division of Hematology-Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA

Correspondence: Michael V. Seiden, M.D., Ph.D., Massachusetts General Hospital, Cox 640, 100 Blossom Street, Boston, Massachusetts 02114, USA. Telephone: 617-724-3123; Fax: 617-724-3166; e-mail: seiden.michael{at}mgh.harvard.edu

Epithelial ovarian carcinomas are successfully treated but seldom cured with standard platinum-based chemotherapy regimens. Investigation continues on the role of high-dose chemotherapy as part of salvage, consolidation and primary induction treatment strategies. Currently, the majority of available clinical studies suggest that modest increases in the dose of platinum in primary induction therapy does not translate into increased survival and comes at the cost of increased toxicity. Interest continues in the use of very high-dose chemotherapy regimens typically with peripheral blood stem cell or bone marrow transplantation. Several series have demonstrated that this approach can provide prolonged disease-free survival in a subset of carefully selected patients with low-volume chemotherapy-sensitive disease. The appropriate application of this expensive and potentially toxic treatment to women with ovarian cancer requires further clinical investigation.

Key Words. Ovarian cancer • Chemotherapy • Hematopoietic stem cell support