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High-Dose Cisplatin with Glutathione Protection in Gynecologic Malignancies

  • Francesco Di Re
  • Silvia Bohm
  • Rosanna Fontanelli
  • Saro Oriana
  • Francesco Raspagliesi
  • Gian Battista Spatti
  • Michele Tedeschi
  • Franco Zunino

Abstract

Cisplatin is one of the most effective antitumor agents currently available for the treatment of malignant disease. It has a broad range of antitumor activity, but it is most recognized for its efficacy in the treatment of testicular and ovarian cancer1,2. Many other genito-urinary and gynecologic tumors have found responsive to the drug3. Cisplatin with or without an alkylating agent is currently regarded as a standard treatment for epithelial ovarian cancer. A dose-intensity analysis of various chemotherapy regimens used in the treatment of ovarian cancer supports a dose-response relationship for cisplatin, since it was found to be the only drug whose dose intensity correlated significantly with response rates4. Clinical and experimental observations of a dose-response effect for cisplatin have stimulated the search for new approaches for dose intensification and escalation. However, the use of high-dose cisplatin is associated with major toxicities which limit treatment duration1,5. The use of intensive hydration protocols and hypertonic saline has allowed a dose escalation of cisplatin beyond 120 mg/m2 with acceptable nephrotoxicity1. However, peripheral neuropathy and ototoxicity have emerged as dose-limiting complications of high-dose therapy that affect more than 50% of treated patients1,6. The severity of these side effects remains a major obstacle to wide-spread use of high doses. Thus, clinical experience with the use of cisplatin doses of more than 100 mg/m2 is still limited in the treatment of advanced epithelial ovarian cancer.

Keywords

Ovarian Cancer Hypertonic Saline Dose Intensification Advanced Epithelial Ovarian Cancer Gynecologic Oncology Group Study 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • Francesco Di Re
    • 1
  • Silvia Bohm
    • 1
  • Rosanna Fontanelli
    • 1
  • Saro Oriana
    • 1
  • Francesco Raspagliesi
    • 1
  • Gian Battista Spatti
    • 1
  • Michele Tedeschi
    • 1
  • Franco Zunino
    • 1
  1. 1.Istituto Nazionale TumoriMilanItaly

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