Treatment of Recurrent Ovarian Cancer: Survey of Practice among Thai Gynecologic Oncologists
Manchana T, MD1, Charakorn C, MD, MSc2, Lertkhachonsuk A, MD, MMed.Ed2, Tangjitgamol S, MD3, Chanpanitkitchot S, MD, MSc4, Srisomboon J, MD5, Thai Gynecologic Cancer Society (TGCS)6
Affiliation : 1 Division of Gynecologic Oncology, Department of Obstetrics & Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 2 Division of Gynecologic Oncology, Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 3 Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand. 4 Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand. 5 Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 6 Thai Gynecologic Cancer Society (TGCS), Bangkok, Thailand
Objective : To survey the practice among Thai gynecologic oncologists in the treatment of recurrent epithelial ovarian cancer.
Materials and Methods : This study was a part of the Thai Gynecologic Cancer Society (TGCS) national survey about the practice
among Thai gynecologic oncologists. Their responses to 21 questions about the treatment of epithelial ovarian cancer were analysed.
Results : Among 258 gynecologic oncologists who met the inclusion criteria, 170 responded to the questionnaires (65.9%). Almost
half of Thai gynecologic oncologists who participated in this survey reported that they performed surgery after recurrence of
ovarian cancer, but in only 10% of their patients. Combination of platinum and paclitaxel was the most preferable regimen (90%)
in recurrent platinum-sensitive epithelial ovarian cancer. The most common second-line chemotherapeutic regimen for recurrent
platinum-resistant or platinum-refractory epithelial ovarian cancer patients was gemcitabine (53.5%) followed by pegylated
liposomal doxorubicin (42.4%) and single paclitaxel (4.1%). Best supportive care was given more frequently after a failure from 2
or more regimens. If the patients did not respond to more than 3 chemotherapy regimens, 70% of the responders offered the best
supportive care to their patients. The responders prescribed targeted therapy with the median number of 5% for their patients.
Conclusion : Chemotherapy was the most common treatment for recurrent ovarian cancer. Reimbursement by the Thai Universal
Health insurance limited using various chemotherapeutic agents including targeted therapy. Best supportive care was wildly
chosen as the treatment option in recurrent platinum-resistant epithelial ovarian cancer patients who failed more than 3
chemotherapy regimens.
Keywords : Chemotherapy, Cytoreductive surgery, Gynecologic oncologist, Recurrent ovarian cancer, Survey
