Are there candidates for high-dose chemotherapy in ovarian carcinoma?

Background: prognosis of advanced ovarian carcinomas (aoc) remains poor with a 5-year survival of 30%. benefit from high-dose chemotherapy (hdc) in this disease has not been demonstrated to date. methods. to evaluate the value of hdc as consolidation treatment after surgery and platinum/taxane-based therapy,we designed a monocentric retrospective comparative study. we used a subset approach to identify parameters associated with hdc efficacy. results: one hundred and three aoc patients treated with conventional chemotherapy alone (cca) were compared to 60 patients receiving hdc plus hematopoietic stem cell support. after a median follow-up of 47.5 months there was no overall survival (os) advantage for the hdc group in the whole population (p=0.29). nevertheless,hdc was associated to a better outcome in young patients (≤50 years),both in term of progression-free survival (p=0.02,log-rank test) and os (p=0.05,log-rank test). median os was 54.6 and 36 months in the hdc and cca groups,respectively. conclusions: although randomized trials failed to demonstrate any benefit for hdc in aoc patients,this study suggests that young patients may derive a substantial advantage from receiving it after the standard treatment. further prospective studies are warranted to confirm this gain and to search for the biological processes associated with this improvement. © 2012 sabatier et al.; licensee biomed central ltd.