Chimiotherapie de primiere ligne des cancers epitheliaux de l'ovaire

Treatment of epithelial ovarian cancer is based mainly on surgery and chemotherapy. Indications of chemotherapy depends on stage of disease and tumor histology. Initial polychemotherapy must be a platinum compound based regimen with respect of dose-intensity. Up to now the initial standard chemotherapy is a cyclophosphamide and platinum combination. Only one randomized study comparing cisplatin-cyclophosphamide and cisplatin-Taxol has been published in patients with macroscopic residual disease (> 1 cm). The improvement of survival with Taxol has led to propose this association as standard treatment in the USA and in some European countries. The place and role of anthracyclines are discussed. New drugs (topotecan, Oxaliplatine) and new modalities of administration (intensification, intraperitoneal route) are currently under evaluation.