I am a 57 year old woman diagnosed with Stage 1c clear cell ovarian cancer. My doctor is recommending 3 cycles of carbo/taxol. I'm concerned that 6 cycles would be better, particularly since it is clear cell, but can't find any definitive research supporting 3 vs. 6. I've heard of very few OVCA patients who've only had 3 cycles.
According to the National Comprehensive Cancer Network (NCCN) guidelines 2009, in women with adequate surgery and staging, the primary treatment of Stage 1C is 3-6 cycles of taxane-carboplatin combination (www.nccn.org).
The evidence supporting the use of three cycles of chemotherapy in Stage 1C clear cell ovarian cancer is sketchy. The study often cited in favor of 3 cycles is Bell J, Brady M, Lage JM, et al's "A randomized phase III trial of three versus six cycles of carboplatin and paclitaxel as adjuvant treatment in early stage ovarian epithelial carcinoma: a Gynecologic Oncology Group study" which appeared in Gynecol Oncol in 2003.
Even in this study, "a trend in favor of the longer treatment program was observed, with a 33% reduction in the risk of recurrence in patients who received six cycles compared to three cycles" (Source: DeVita et al, Principles and Practice of Oncology, 8th Edition, LWW).
Because of uncertainties about this issue, many oncologists prefer to administer the more traditional regime of six cycles of carboplatin-paclitaxel. However, the final decision on this must be made only by the team of treating oncologists and the patient herself after weighing all evidence and applying them to the unique case being treated.
All the best, and God Bless!
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