***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Both weekly cisplatin chemotherapy and single agent topotecan have proven to be effective in recurrent ovarian cancer . Pre clinical data show synergism between cisplatin and topotecan .  Side effects for this combination are drug sequence dependent and predominantly haematologic . Since pre clinical data suggest that Cremophor EL ( CrEL ) , the formulation vehicle of paclitaxel , has a protective effect on haematological toxicity of cisplatin , CrEL was added to the combination cisplatin and topotecan . In this phase I study , escalating doses of oral topotecan administered on day 1 , 2 , 8 , 9 , 15 , 16 , 29 , 30 , 36 , 37 , 43 , 44 were combined with weekly cisplatin 70 mg m–2d–1on day 1 , 8 , 15 , 29 , 36 , 43 ( scheme A ) or with the presumably less myelotoxic sequence weekly cisplatin day 2 , 9 , 16 , 30 , 37 , 44 ( scheme B ) . In scheme C , CrEL 12 ml was administered prior to cisplatin in the sequence of Scheme A. 18 patients have received a total of 85 courses . In scheme A 4/10 patients , all treated with topotecan 0.45 mg m–2d–1 , experienced DLT : 1 patient had vomiting grade 4 , 1 patient had grade 4 neutropenia > 5 days , 1 patient had > 2 weeks delay due to thrombocytopenia and 1 patient due to neutropenia . Both patients in scheme B ( topotecan 0.45 mg m–2d–1 ) had DLT due to a delay > 2 weeks because of prolonged haematological toxicity . No DLT was observed in the first 3 patients in scheme C ( topotecan 0.45 mg m–2d–1 ) . However , 2 out of 3 patients treated at dose level topotecan 0.60 mg m–2d–1 in scheme C experienced DLT due to > 2 weeks delay because of persistent thrombocytopenia or neutropenia . We conclude that there is a modest clinical effect of CrEL on haematological toxicity for this cisplatin-based combination regimen , which seems to reduce these side effects but does not really enable an increase of the oral topotecan dose . © 2001 Cancer Research Campaign PURPOSE OF INVESTIGATION This study was conduced to assess the results of paclitaxel plus cisplatin given over six months as firstline therapy in women with stage III and IV epithelial ovarian cancer with residual disease < 1 cm and compare it to our previous st and ard of cisplatin , adriamycin , and cyclophosphamide given over ten months in two sequential trials totaling 100 patients . METHODS We compared induction weekly cisplatin ( 1 mg/kg x 4 ) followed by monthly cisplatin ( 50 mg/m2 ) , doxorubicin ( 50 mg/m2 ) and cyclophosphamide ( 750 mg/m2 ) x 10 ( n = 56 ) versus induction cisplatin ( 1 mg/kg x 4 ) followed by cisplatin ( 75 mg/m2 ) and paclitaxel ( 135 mg/m2 ) monthly over six months ( n = 44 ) . RESULTS The two groups were similar in age , histologic subtypes , grade , performance status , and substage . The mean dose of cisplatin in the PAC patients was 617.1 ( + /-92.7 ) mg/m2 as compared to 567.1 ( + /-89.2 ) mg/m2 in the TP patients ( p < 0.0001 ) . Surgical response was assessed in 83.9 % of the PAC and 86.4 % of the TP patients . The incidence of nausea and vomiting , myelotoxicity and renal toxicity were similar in the two groups . Peripheral neuropathy occurred more frequently following TP ( 57 % vs 16 % ; p = 0.001 ) . Cardiac toxicity ( grade 1 ) occurred in 39 % of the PAC patients and in 4.5 % of the TP patients ( p < 0.001 ) . The overall response rate ( 75 % vs 88.7 % ) , surgical response rate ( 67.9 % vs 79.5 % ) , complete surgical responses ( 37.5 % vs 40.9 % ) , estimated two-year survival ( 80.2 % vs 79.6 % ) , progression-free median survival ( 36 months vs 30.4 months ) and two-year progression/recurrence rates ( 32.3 % vs 46.9 % ) , respectively , of PAC and TP patients were not statistically significant ( p = NS ) . CONCLUSIONS Given the discussed limitations of the study , compared with PAC , TP did not improve overall and surgical response rates , two-year survival , two year disease-free survival , or median time of recurrence in patients with optimal ( < 1 cm ) stage III and IV ovarian cancer and result ed in higher peripheral neuropathy rates OBJECTIVE A prospect i ve phase II study was conducted to evaluate the efficacy and toxicity of oxaliplatin plus 5-fluoruracil ( 5-FU ) and high-dose leucovorin ( LV ) ( FOLFOX-4 ) in patients with platinum-resistant , taxane-pretreated recurrent ovarian cancer . PATIENTS AND METHODS Thirty-eight patients , with a median age of 58 years ( range 33 - 77 ) , were treated with oxaliplatin 85 mg m(-2 ) as a 2-h infusion on day 1 , LV 200 mg m(-2 ) day(-1 ) as a 2-h infusion followed by bolus 5-FU 400 mg m(-2 ) day(-1 ) and a 22-h infusion of 5-FU 600 mg m(-2 ) day(-1 ) for 2 consecutive days . Treatment was repeated every 3 weeks . Patients were evaluated for response every two cycles . RESULTS The vast majority of patients had performance status 0 or 1 and 76.3 % had > or = 2 metastatic sites . A median number of four cycles per patient ( range , 1 - 8 ) were administered . Based on an intention-to-treat analysis , 3 patients ( 7.9 % ) achieved a complete response ( CR ) and 8 ( 21.1 % ) achieved a partial response ( PR ) , for an overall response rate of 29 % . Another 29 % of patients had stable disease ( SD ) . The median relapse-free survival was 5.2 months ( range 2.5 - 17 ) , the median time to tumor progression was 4.8 months ( range 0.6 - 19 ) , and the median overall survival was 10.1 months ( range 0.2 - 36 ) . Toxicity was mild to moderate . Grade 3/4 neutropenia and thrombocytopenia occurred in 29 % and 21.1 % of patients , respectively . Febrile neutropenia was encountered in 3 patients ( 7.9 % ) , who were successfully treated . Grade 3/4 neurotoxicity developed in 15.8 % of patients ; neurotoxicity gradually declined after treatment discontinuation . Alopecia , nausea-vomiting , diarrhea , mucositis , and asthenia were not a serious problem . There were no treatment-related deaths . CONCLUSION The combination of oxaliplatin and 5-FU/LV ( FOLFOX-4 ) appears to be an effective regimen with a good toxicity profile for the treatment of platinum-resistant , taxane-pretreated ovarian cancer 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 r and omized 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 r and omly 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 This r and omized , open label , phase III clinical trial ( 1988 - 1992 ) compared the efficacy and safety of a dose-dense regimen of single-agent cisplatin with a st and ard 3-weekly schedule in first-line chemotherapy for advanced epithelial ovarian cancer . Two hundred eighty-five patients were r and omly assigned to the experimental dose-dense arm ( cisplatin 50 mg/m(2 ) weekly × nine cycles ) or to the control ( st and ard treatment ) arm ( cisplatin 75 mg/m(2 ) , administered on day 1 every 21 days × six cycles ) . The primary outcome was progression-free survival ( PFS ) . Secondary outcomes were overall survival ( OS ) , overall response to chemotherapy , and toxicity . Toxicity and response to treatment were compared with the χ(2 ) test using trend or exact correction . PFS and OS were estimated by Kaplan-Meier analyses and treatment hazard ratios ( HRs ) with the Cox proportional hazards model . All statistical tests were two-sided . After a median follow-up of 16.8 years , no differences were observed between the two treatments in PFS ( experimental arm : 17.2 months ; control arm : 18.1 months ; HR = 1.08 , 95 % confidence interval [ CI ] = 0.83 to 1.40 ; P = .57 ) and in OS ( experimental arm : 35 months ; control arm : 32 months ; HR = 0.97 , 95 % CI = 0.75 to 1.26 ; P = .97 ) . Thus , increasing dose intensity of cisplatin does not improve PFS or OS compared with st and ard chemotherapy From December 1986 to April 1990 , 40 consecutive ovarian cancer patients who relapsed after response to cisplatin-based chemotherapy regimens were treated with seven courses of weekly cisplatin , in combination with epirubicin or etoposide . The overall response rate obtained with the intensive schedule was 60 % and the complete response rate was 25 % ; median duration of response was 7 months and median survival time , 13.5 months . Responsive cases seem to have longer survival ; a prognostic factor for response to salvage treatment and longer survival is the disease-free interval after the first-line chemotherapy . Weekly cisplatin as intensive treatment was very well tolerated and showed acceptable toxicity in both the combination protocol s with epirubicin or etoposide 
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Results : This proposed systematic review will evaluate the efficacy of WC  for  patients with OC .
Conclusion : The findings of this study may summarize the latest evidence for the WC  on OC .