Academic literature on the topic 'Ovarian cancer, cisplatin, dose intensity'

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Journal articles on the topic "Ovarian cancer, cisplatin, dose intensity"

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Levin, L., and W. M. Hryniuk. "Dose intensity analysis of chemotherapy regimens in ovarian carcinoma." Journal of Clinical Oncology 5, no. 5 (May 1987): 756–67. http://dx.doi.org/10.1200/jco.1987.5.5.756.

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The relationship between outcome and dose intensity was analyzed for first-line chemotherapy of advanced ovarian cancer using a particular CHAP (cyclophosphamide, hexamethylmelamine, Adriamycin [Adria Laboratories, Columbus, OH], cisplatin) regimen as the standard. Previously described techniques were used to calculate the average dose intensity of regimens containing one, two, three, or all four drugs of CHAP, relative to the standard. The average relative dose intensity, especially the relative dose intensity of cisplatin, correlated significantly with clinical response and with median survival time (MST) of the entire group (not just the remitters). There was a distinct advantage for multiagent regimens over single alkylating agents and especially for multiagent regimens containing cisplatin. Survival correlated with response rate (of multiagent regimens). This analysis suggests that dose intensity is a determinant of treatment outcome. Prospective randomized trials would be required to test whether, and to what extent, dose intensity determines outcome independently of total amount of drug given, performance status, or other factors. If dose intensity does determine outcome, methods of increasing it should be tested in an attempt to improve treatment results.
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McGuire, W. P., W. J. Hoskins, M. F. Brady, H. D. Homesley, W. T. Creasman, M. L. Berman, H. Ball, J. S. Berek, and J. Woodward. "Assessment of dose-intensive therapy in suboptimally debulked ovarian cancer: a Gynecologic Oncology Group study." Journal of Clinical Oncology 13, no. 7 (July 1995): 1589–99. http://dx.doi.org/10.1200/jco.1995.13.7.1589.

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PURPOSE We report a prospective randomized trial in women with advanced ovarian cancer to evaluate the importance of chemotherapy dose-intensity on survival, progression-free survival (PFS), and response. PATIENTS AND METHODS A total of 485 patients with epithelial ovarian cancer and residual masses more than 1 cm following surgery (stage III presentation) or any stage IV presentation were randomly assigned to receive either standard therapy (cyclophosphamide 500 mg/m2 and cisplatin 50 mg/m2 intravenously every 3 weeks for eight courses) or intense therapy (cyclophosphamide 1,000 mg/m2 and cisplatin 100 mg/m2 intravenously every 3 weeks for four courses). Dose modification was rigidly controlled to maintain intensity. Clinical and pathologic responses were assessed, when appropriate, as well as PFS interval and survival. RESULTS A total of 458 patients met all eligibility criteria and were assessed for survival and PFS. The dose-intensive group received the same total dose of cyclophosphamide and cisplatin, but 1.97 times greater dose-intensity than the standard group. Clinical and pathologic response rates; response duration, and survival were similar in both groups of patients. Hematologic, gastrointestinal, febrile episodes, septic events, and renal toxicities were significantly more common and severe in the dose-intensive group. CONCLUSION A doubling of the dose-intensity in the treatment of bulky ovarian epithelial cancers led to no discernible improvement in patient outcome and was associated with more severe toxicity. This study provides no evidence to support the hypothesis that modest increases in dose-intensity without increasing total dose are associated with significant improvement in overall survival or PFS.
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Conte, P. F., M. Bruzzone, F. Carnino, A. Gadducci, R. Algeri, A. Bellini, F. Boccardo, et al. "High-dose versus low-dose cisplatin in combination with cyclophosphamide and epidoxorubicin in suboptimal ovarian cancer: a randomized study of the Gruppo Oncologico Nord-Ovest." Journal of Clinical Oncology 14, no. 2 (February 1996): 351–56. http://dx.doi.org/10.1200/jco.1996.14.2.351.

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PURPOSE The aim of the study was to compare high-versus low-dose cisplatin in combination with cyclophosphamide and epidoxorubicin as primary chemotherapy for suboptimal stage III and IV ovarian cancer. PATIENTS AND METHODS One hundred forty-five patients were randomized to receive six courses of cisplatin 50 or 100 mg/m2 plus epidoxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2. The two treatment arms were well balanced; all patients had greater than 2 cm and 37.2% had greater than 5 cm of residual disease; 29.6% had stage IV disease. RESULTS Patients in the high-dose arm received a double dose-intensity and double total dose of cisplatin. The high-dose regimen induced significantly more episodes of leukopenia (47.8% v 32.8%, P = .05), thrombocytopenia (21.7% v 3.2%, P = .003), anemia (37.6% v 12.5%, P = .002), nephrotoxicity (six v one patient), and neurotoxicity (30.4% v 6.3%, P = .002). There were no significant differences in efficacy in terms of clinical response rate (high-dose 57.5% v low-dose 61.1%), pathologic complete response (CR) (9.6% v 18.1%), median survival times (29 v 24 months), and median progression-free survival (18 v 13 months). CONCLUSION This study shows that doubling the dose-intensity and total dose of cisplatin in combination with epidoxorubicin and cyclophosphamide has significant toxic effects and does not improve clinical outcome in patients with suboptimal ovarian cancer.
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Gandara, D. R., W. A. Nahhas, M. D. Adelson, S. M. Lichtman, E. S. Podczaski, S. Yanovich, H. D. Homesley, P. Braly, P. S. Ritch, and S. R. Weisberg. "Randomized placebo-controlled multicenter evaluation of diethyldithiocarbamate for chemoprotection against cisplatin-induced toxicities." Journal of Clinical Oncology 13, no. 2 (February 1995): 490–96. http://dx.doi.org/10.1200/jco.1995.13.2.490.

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PURPOSE Diethyldithiocarbamate (DDTC) blocks cisplatin-induced toxicities in animal models without inhibiting antitumor effects. DDTC chemoprotection was tested in a randomized, multicenter, double-blind comparison versus placebo (PB) in patients with lung or ovarian cancer. Primary end points were nephrotoxicity, ototoxicity, neuropathy, and completion of therapy. PATIENTS AND METHODS Between April 1990 and February 1992, 221 patients were registered with small-cell lung cancer (SCLC), non-small-cell lung cancer (NSCLC), or ovarian cancer. Cisplatin (100 mg/m2) and cyclophosphamide (in ovarian cancer) or etoposide (in lung cancer) were administered with either DDTC (1.6 g/m2 over 4 hours) or PB intravenously, every 4 weeks for a planned six cycles. RESULTS At an interim safety analysis, data were available for 195 patients from the combined lung and ovarian cancer populations (PB, 99 patients; DDTC, 96 patients). Withdrawal for chemotherapy-induced toxicities occurred in 9% of PB-treated patients and 23% of DDTC-treated patients (P = .008). The mean cisplatin delivered dose-intensity (DDI) was 23 mg/m2/wk on both arms. However, the mean cisplatin cumulative dose delivered (CDD) was 379 mg/m2 on the PB arm, compared with 247 mg/m2 on the DDTC arm (P = .0001). At the time of interim analysis, 28% of PB-treated patients had completed all six cycles of therapy, compared with only 6% of DDTC-treated patients (P < .001). Although, clinical hearing loss, neuropathy, emesis, and myelosuppression were equivalent in the two treatment arms, DDTC-treated patients had more nephrotoxicity as determined by changes in serum creatinine concentration. Toxicities related to DDTC infusion included transient hypertension, flushing, and hyperglycemia. DDTC did not compromise response rates in either tumor type. CONCLUSION This study did not demonstrate a significant chemoprotective effect against cisplatin-induced toxicities with the DDTC dose schedule tested. Patients who received DDTC received lower cumulative doses of cisplatin, but were more likely to be withdrawn from treatment early due to chemotherapy-related toxicities.
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Gore, M., P. Mainwaring, R. A'Hern, V. MacFarlane, M. Slevin, P. Harper, R. Osborne, et al. "Randomized trial of dose-intensity with single-agent carboplatin in patients with epithelial ovarian cancer. London Gynaecological Oncology Group." Journal of Clinical Oncology 16, no. 7 (July 1998): 2426–34. http://dx.doi.org/10.1200/jco.1998.16.7.2426.

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PURPOSE We have examined the role of an increase in cisplatin dose-intensity in patients with advanced epithelial ovarian cancer by means of single-agent carboplatin therapy. PATIENTS AND METHODS Two hundred twenty-seven patients were randomized to treatment and eligible for analysis. The dose of carboplatin was calculated according to the Calvert formula. One hundred seventeen patients received carboplatin at an area under the concentration time curve (AUC) of 6 for six courses, administered every 28 days, and 110 patients received carboplatin at an AUC of 12 for four courses, administered every 28 days. Patients were eligible provided they had not received prior chemotherapy or radiotherapy and had International Federation of Gynecology and Obstetrics stages II to IV or relapsed stage I epithelial ovarian cancer. RESULTS The planned total-dose increase was 33% for the patients treated with carboplatin AUC 12, but the received percentage total-dose increase was 20%. There were no differences in progression-free or overall survival between the two treatment arms; the overall survival rate at 5 years was 31% and 34% of patients treated at AUCs 6 and 12, respectively. There was significantly more toxicity associated with carboplatin AUC 12, which resulted in more treatment delays and/or dose reductions (52% v 18%; P < .001). CONCLUSION We have shown that carboplatin can be delivered at an AUC of 12 for four courses without granulocyte colony-stimulating factor support, although significant hematologic toxicity occurs. Nonhematologic toxicities were not clinically significant. Carboplatin offers an opportunity to intensify cisplatin therapy, but a greater than two-fold increase in dose-intensity probably needs to be achieved before significant effects on survival will be produced and hematologic support will be required.
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Von Hoff, D. D., G. M. Clark, G. R. Weiss, M. H. Marshall, J. B. Buchok, W. A. Knight, and C. F. LeMaistre. "Use of in vitro dose response effects to select antineoplastics for high-dose or regional administration regimens." Journal of Clinical Oncology 4, no. 12 (December 1986): 1827–34. http://dx.doi.org/10.1200/jco.1986.4.12.1827.

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Several preclinical and clinical studies have documented that dose or dose intensity of chemotherapeutic agents are important factors for response of patients' tumors. This finding has prompted empiric trials of certain chemotherapeutic agents in high-dose or regional administration treatment regimens. The present study was performed to identify agents that would be particularly good candidates for high-dose or regional administration regimens against particular types of tumors. Using a human tumor cloning technique, we constructed dose in vitro response lines for ten different chemotherapeutic agents against seven different histologic types of malignancies. Slopes of the lines indicated the agents with the greatest increases of in vitro response per increment in dose of the agent. Tumors against which the agents gave the steepest dose response lines included lymphoma, head and neck cancer, ovarian cancer, and small-cell lung cancer, while the dose response lines for non-small-cell lung cancer, breast cancer, and colon cancer were quite flat. Suggestions for clinical trials based on these findings include the use of high-dose melphalan for patients with lymphoma, head and neck, and ovarian cancer; the use of mitoxantrone in high-dose regimens for patients with breast cancer; high-dose cisplatin regimens for patients with small-cell lung cancer; high-dose bleomycin regimens for patients with non-small-cell lung and head and neck cancer; and regional perfusion of liver metastases from colorectal cancer with cisplatin. Prospective testing of high-dose or regional administration regimens suggested by this new model should indicate its use for prediction of the best agent to use in high-dose regimens against a particular tumor type.
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Kudelka, A. P., D. Tresukosol, C. L. Edwards, R. S. Freedman, C. Levenback, P. Chantarawiroj, C. Gonzalez de Leon, et al. "Phase II study of intravenous topotecan as a 5-day infusion for refractory epithelial ovarian carcinoma." Journal of Clinical Oncology 14, no. 5 (May 1996): 1552–57. http://dx.doi.org/10.1200/jco.1996.14.5.1552.

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PURPOSE To determine the efficacy and toxicity of topotecan administered as a 5-day intravenous infusion in patients with advanced ovarian cancer refractory to cisplatin-based chemotherapy. PATIENTS AND METHODS Thirty patients with advanced epithelial ovarian cancer refractory to cisplatin-based chemotherapy received intravenous infusions of topotecan 1.5 mg/m2 delivered over 30 minutes each day for 5 days. A course was repeated every 21 days. The patient eligibility requirements included age > or = 18 years, Zubrod score < or = 2, measurable disease, adequate hepatic and renal function, neutrophil count > or = 1,500/microL, platelet count > or = 100,000/microL, and anticipated survival > or = 3 months. RESULTS Twenty eight patients were assessable for response and toxicity. All patients were assessable for survival. The major toxicity from administration of topotecan at this dose schedule was myelosuppression; 21 patients required dose reductions. Four patients had neutropenic fever that required hospitalization, and seven patients required platelet transfusions. Maculopapular pruritic exanthema occurred in 20% of patients; gastrointestinal side effects were mild. No deaths were reported on the study. At dose levels of 1.5, 1.25, and 1.0 mg/m2, 61%, 31%, and 25% of patients, respectively, required dose reductions. Of 28 assessable patients, four (14%; 95% confidence interval [CI], 4% to 34%) achieved a partial response (PR) at a median of 1.4 months and lasting 8.9 months, and 17 had stable disease (SD). The overall median survival time was 10.0 months (95% CI, 8.1 to 13.5). CONCLUSION Topotecan shows modest clinical activity against cisplatin-refractory ovarian cancer, although the dose-intensity is compromised by the depth of the granulocyte nadir and the duration of granulocytopenia. Further studies of topotecan may necessitate a reevaluation of optimal dose schedule, with the possible incorporation of multilineage cytokines, and its activity in taxane-resistant tumors.
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Creemers, G. J., G. Bolis, M. Gore, G. Scarfone, A. J. Lacave, J. P. Guastalla, R. Despax, et al. "Topotecan, an active drug in the second-line treatment of epithelial ovarian cancer: results of a large European phase II study." Journal of Clinical Oncology 14, no. 12 (December 1996): 3056–61. http://dx.doi.org/10.1200/jco.1996.14.12.3056.

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PURPOSE Topotecan is a topoisomerase I inhibitor with preclinical activity against various tumor types. We conducted a large multicenter phase II study with topotecan in ovarian cancer in patients who had failed to respond to one prior cisplatin-based chemotherapeutic regimen. PATIENTS AND METHODS Topotecan 1.5 mg/m2/d was administered intravenously by 30-minute infusion for 5 days repeated every 3 weeks. As the cisplatin-free interval relates to response in subsequent treatment, patients were stratified in subgroups, ie, cisplatin-refractory, cisplatin-resistant, and cisplatin-sensitive. RESULTS One-hundred eleven patients entered the study. Nineteen patients were considered to be ineligible; 92 patients were assessable for response. A total of 552 courses were given (median, four per patient; range, one to 17). The major toxicities were leukocytopenia and neutropenia, which were grade 3 to 4 in 54.2% and 69.1% of courses, respectively, but with only 4.3% of these being grade 4 neutropenia plus fever or infectious complications. Prophylactic granulocyte colony-stimulating factor (G-CSF) was given in 20.5% of courses to maintain dose-intensity. Other relatively frequent side effects were alopecia (82%), nausea (36.4%), and vomiting (17.5%). The overall response rate was 16.3%, with one complete response (CR) and 14 partial responses (PRs). In the cisplatin-refractory, cisplatin-resistant, and cisplatin-sensitive strata, the response rates were 5.9%, 17.8%, and 26.7%, respectively. The median duration of time of documented response was 21.7 weeks (range, 4.6 to 41.9). CONCLUSION Topotecan in a daily-times-five schedule is an effective regimen as second-line treatment in ovarian cancer. Further investigations of topotecan in ovarian cancer, including first-line use and combination with other active agents, are indicated.
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Bolis, G., G. Favalli, S. Danese, F. Zanaboni, G. Mangili, C. Scarabelli, S. Tateo, et al. "Weekly cisplatin given for 2 months versus cisplatin plus cyclophosphamide given for 5 months after cytoreductive surgery for advanced ovarian cancer." Journal of Clinical Oncology 15, no. 5 (May 1997): 1938–44. http://dx.doi.org/10.1200/jco.1997.15.5.1938.

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PURPOSE To compare the efficacy of a treatment with cisplatin plus cyclophosphamide given for 5 months and a short treatment with cisplatin alone in advanced ovarian cancer, we conducted a multicenter randomized clinical trial. PATIENTS AND METHODS Eligibility criteria were as follows: first diagnosis of histologically confirmed invasive epithelial ovarian cancer of International Federation of Gynecology and Obstetric (FIGO) stage III-IV, age younger than 75 years, and Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2. Within 28 days of cytoreductive surgery, eligible women were randomly assigned treatment with weekly cisplatin 50 mg/m2 for nine courses or cisplatin 75 mg/m2 plus cyclophosphamide 750 mg/m2 every 21 days for six courses. RESULTS A total of 607 women were entered onto the study. There was no difference in the response to treatment. Pathologic complete response (CR) was documented in 63 of the weekly cisplatin cases and 70 of the cisplatin plus cyclophosphamide group (chi 1(2) = 1.43; P = .23). The median follow-up time was 3 years. There were 151 and 148 deaths in the weekly cisplatin and cyclophosphamide plus cisplatin arms, respectively. Survival curves were similar in the two groups, with a 3-year percent survival estimate of 44.1 (SE = 3.4) in the weekly cisplatin and 44.6 (SE = 3.4) in the cisplatin plus cyclophosphamide group (log-rank test chi 1(2) = 0.004; P = .96). CONCLUSION This study found that 2-month monochemotherapy treatment with cisplatin was as effective as 5-month polychemotherapy including cisplatin at a similar doses but different dose-intensity plus cyclophosphamide.
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Shibata, K., F. Kikkawa, M. Mika, Y. Suzuki, H. Kajiyama, K. Ino, and S. Mizutani. "Neoadjuvant chemotherapy for FIGO stage III or IV ovarian cancer: Survival benefit and prognostic factors." International Journal of Gynecologic Cancer 13, no. 5 (2003): 587–92. http://dx.doi.org/10.1136/ijgc-00009577-200309000-00003.

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The survival benefit of neoadjuvant chemotherapy (NAC) was assessed in patients with FIGO stage III or IV ovarian cancer, and the prognostic value of various therapeutic factors was determined. In patients treated for stage III or IV ovarian malignancies at the Department of Obstetrics and Gynecology of Nagoya University or related institutions between 1987 and 1996, 119 had a histologic diagnosis of serous cystadenocarcinoma. For this group, the long-term outcome was compared between 96 patients receiving conventional adjuvant chemotherapy following standard surgery and 23 patients treated with NAC, both followed by a second cytoreductive surgery. In a total of 29 patients with all histologic types of malignancy, the tumor response to NAC and survival were analyzed on the basis of histology, chemotherapy regimen, residual tumor size after the second cytoreductive operation, and the dose intensity of cisplatin. The long-term outcome (5-year survival rate) was better in patients treated with conventional adjuvant chemotherapy than in patients receiving NAC, although the difference was not significant. Overall survival did not differ significantly in relation to tumor histology or chemotherapy regimen. With respect to residual tumor size after the second surgery, patients with a residual tumor ≦ 2 cm in diameter had a significantly better prognosis than those with a residual tumor >2 cm. A better prognosis was also associated with a higher dose intensity of cisplatin, and patients treated at ≧ 18 mg/m2/week survived significantly longer than those receiving <18 mg/m2/week.
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Dissertations / Theses on the topic "Ovarian cancer, cisplatin, dose intensity"

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FRUSCIO, ROBERT. "Somministrazione settimanale di cisplatino in pazienti con carcinoma ovarico in stadio avanzato: risultati a lungo termine di uno studio clinico randomizzato." Doctoral thesis, Università degli Studi di Milano-Bicocca, 2010. http://hdl.handle.net/10281/13832.

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OBJECTIVES: to determine the effect of weekly administration of cisplatin as first line chemotherapy for advanced ovarian cancer patients METHODS: Patients with advanced epithelial ovarian cancer were randomly assigned (by a computer system) to the experimental dose-dense first line chemotherapic arm (Pw, cisplatin 50 mg/mq weekly x 6 cycles) or to the standard arm (Pst, cisplatin 75 mg/mq every three weeks x 6 cycles). Planned cumulative dose of cisplatin was 450 mg/m2 in both groups, while dose intensity was doubled in the Pw arm (50 mg/m2/week versus 25 mg/m2/week). The primary objective of the study was to compare the progression free survival (PFS) in the two arms. Secondary objectives were the overall response to chemotherapy and toxicity. RESULTS: between November 1988 and February 1992 285 patients were randomized in the two treatment arms. The two regimens resulted equally feasible. Planned dose intensity was achieved in both treatment groups (median 45 and 23 mg/m2/week). Toxicity was similar in the two groups, with the exception of grade 3-4 leukopenia which was more frequent in the experimental arm (9% vs 3%, p:0.02). Median follow up was 16.8 years. There were no differences between the two treatment arms in terms of PFS (17 months in the Pw arm, 18 in the Pst arm, p:0.57) and in terms of OS (35 months in the Pw arm, 32 in the Pst arm, p:0.97). CONCLUSION: dose-dense cisplatin is well tolerated, but does not seem to bring advantages, in terms of PFS and OS, compared to standard chemotherapy.
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Book chapters on the topic "Ovarian cancer, cisplatin, dose intensity"

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Levin, L. "Chemotherapy options in ovarian carcinoma — a dose intensity perspective." In Ovarian Cancer 3, 195–201. Boston, MA: Springer US, 1995. http://dx.doi.org/10.1007/978-1-4757-0136-4_20.

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Muggia, F. M., and I. Gill. "Optimizing Dose-Intensity: Combining Carboplatin with Cisplatin." In Platinum and Other Metal Coordination Compounds in Cancer Chemotherapy, 471–80. Boston, MA: Springer US, 1991. http://dx.doi.org/10.1007/978-1-4899-0738-7_45.

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Nichols, Craig R., Stephen D. Williams, Patrick J. Loehrer, and Lawrence H. Einhorn. "Cisplatin Dose-intensity in Testicular Cancer Treatment: Analysis of a Randomized Clinical Trial." In Platinum and Other Metal Coordination Compounds in Cancer Chemotherapy, 409–20. Boston, MA: Springer US, 1991. http://dx.doi.org/10.1007/978-1-4899-0738-7_38.

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Sawada, M. "Antitumor Effects of High-Dose Cisplatin in Hypertonic Saline Against Human Ovarian Tumors Heterotransplanted in Nude Mice." In Platinum and Other Metal Coordination Compounds in Cancer Chemotherapy, 504–7. Boston, MA: Springer US, 1988. http://dx.doi.org/10.1007/978-1-4613-1717-3_58.

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Cure, Hervé. "Dose Intensity in the Treatment of Advanced Epithelial Ovarian Cancer." In Gynecologic Cancer, 479–89. Elsevier, 2004. http://dx.doi.org/10.1016/b978-0-443-07142-3.50039-7.

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Conference papers on the topic "Ovarian cancer, cisplatin, dose intensity"

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Elagwany, A. "EP835 Value of reducing intraperitoneal cisplatin dose in debulked advanced epithelial ovarian cancer." In ESGO Annual Meeting Abstracts. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/ijgc-2019-esgo.884.

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Wilson, Andrew, Lanzi Sinaise, Jade M. Readus, Michelle Park, Anum S. Lalani, Jeanette Saskowski, and Dineo Khabele. "Abstract 1016: Combination low dose 5-azacytidine (AZA) and romidepsin (FK228) therapy re-sensitizes ovarian cancer cells to cisplatin." In Proceedings: AACR 104th Annual Meeting 2013; Apr 6-10, 2013; Washington, DC. American Association for Cancer Research, 2013. http://dx.doi.org/10.1158/1538-7445.am2013-1016.

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