Chithra Devi, V (2010) Tumor Clearance in Advanced Ovarian Cancer With and Without Neoadjuvant Chemotherapy. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Ovarian tumors are one of the most common gynecological malignancy in India. It is the leading cause of death from malignancies arising in female genital tract. Patients with ovarian tumors are often symptom free for a long time. By the time ovarian malignancy is diagnosed, about 2/3rd of these have already become far advanced and the prognosis in such cases is unfavourable. Patients with advanced ovarian cancer should be treated by radical debulking surgery aiming at complete tumor resection. But 70% of the patients present with advanced disease optimal debulking cannot be obtained due to multifactorial reasons like biological aggressiveness of tumors, coexisting medical problem and experience of surgeon. Many trials proved that giving neoadjuvant chemotherapy and post chemotherapy debulking had significant improvement in progression free interval and overall survival. It also permits a less aggressive surgery to be performed. AIM OF THE STUDY: The Aim is to study the tumor clearance effect of neoadjuvant chemotherapy in advanced ovarian tumor in terms of optimal debulking, ascitic fluid volume reduction, blood transfusion requirements and to compare it with those who have not received neoadjuvant chemotherapy. Study: Prospective study. Setting: Patients with advanced ovarian tumor admitted in Institute of Social Obstetrics, Triplicane, Chennai-5 from July 2008 to Dec 2009 were included in the study. MATERIALS: Inclusion Criteria: • Patients with advanced epithelial ovarian tumor (stage 3 & 4). • No previous Chemotherapy. • No Previous Surgery for the same complaint. • Willing to take neoadjuvant Chemotherapy and then follow it up with surgery. Exclusion Criteria: • Early stage epithelial ovarian tumor (Stage 1 & 2). • Borderline tumor. • Non-epithelial ovarian tumor. • Those who were treated with some form of Oncotherapy. • Not willing to wait for surgery following CT. METHODOLOGY: All patients enrolled in the study will undergo detailed physical examination, routine hematological, biochemical investigations, Ultrasound and CT Scan. For those patients with ascites, ascitic fluid sent for cytology. If Cytology report cofirms that it is Epithelial ovarian tumor. Patient receives Neoadjuvant chemotherapy of Cisplatin 75mg/sq.m, Cyclophosphamide 750mg/sq. m for 3 cycles – 6 weeks After 6 weeks, undergo interval debulking surgery. Optimal Debulking, Ascitic fluid volume, Blood transfusion rate are compared with the control group. Control group in this study will be those patients with advanced epithelial tumor who have not received neoadjuvant chemotherapy and undergone primary cytoreductive surgery in the past in Institute of Social Obstetrics, Triplicane, Chennai – 5. The results were analysed using Chi-Square tests. CONCLUSION: Neo adjuvant chemotherapy is significantly more effective in achieving optimal cytoreduction and reducing ascitic fluid volume in advanced ovarian cancer. Blood transfusion requirement is significantly less in neo adjuvant chemotherapy group. Adhesions are found to be significantly less in NACT group.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Tumor clearance ; advanced ovarian cancer ; with neoadjuvant chemotherapy ; without neoadjuvant chemotherapy |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 25 Nov 2017 11:39 |
| Last Modified: | 09 Dec 2017 11:32 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4093 |
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