Comparison of regression induction with triethylenethiophosphoramide or methotrexate in bulky stage IIIb ovarian carcinoma.

Twenty-two patients were treated for bulky stage IIIb and/or stage IV ovarian cancer with methotrexate (MTX), triethylenethiophosphoramide (thio-TEPA), or combination of the two. Two cycles of MTX 3 weeks apart failed to result in any important tumor shrinkage in 9 to 10 patients; thio-TEPA, in contrast, produced a rapid objective tumor regression in 8 of 12 patients. In addition, 4 of 8 patients who had not responded to MTX showed greater than 50% objective tumor regression during the first 4 weeks after crossover to thio-TEPA. The kinetics or drug penetration factor of the cell cycle-specific agent (MTX) in two oral cycles was of no clinical value alone in bulky ovarian cancer.