Second line platinum-based intraperitoneal chemotherapy for advanced ovarian cancer

Acta Obstet Gynecol Scand. 2009;88(4):463-7. doi: 10.1080/00016340902777525.

Abstract

Objective: To report the results of ovarian cancer treatment, where a regimen of intravenous cyclophosphamide followed by intraperitoneal cisplatin or carboplatin was administered as second line treatment.

Design: Retrospective observational study on 198 women with stage I-IV histologically documented epithelial ovarian cancer after one or more prior regimens of chemotherapy.

Setting: University tertiary referral clinic, Gdansk, Poland.

Methods: The study group was recruited from among 593 ovarian cancer patients treated between January 1996 and December 2006. Conditions of inclusion for intraperitoneal treatment were: relapse or recurrence of disease after surgery followed by first line treatment. Recurrences were confirmed through re-staging laparotomy or second-look laparotomy. Patients received 90 mg/m(2) cisplatin, or carboplatin AUC 6 intraperitoneally and cyclophosphamide 750 mg/m(2) intravenously. Four or six courses were planned for each patient.

Main outcome measures: Response to treatment defined as complete or partial response, or progressive disease, and survival rates.

Results: There were 67 (34%) with complete and 61 (31%) with partial response, while 69 (35%) developed progressive disease. Median survival from the initiation of intraperitoneal chemotherapy (IP) was 51 months and significantly longer for patients who received four cycles of IP: 78 months vs. 20 months for patients who received six intraperitoneal cycles.

Conclusions: IP can be used in second line treatment of ovarian cancer, but six treatment cycles appear associated with worse results compared to four.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / therapeutic use
  • Cisplatin / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Disease Progression
  • Female
  • Humans
  • Infusions, Intravenous
  • Infusions, Parenteral*
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / mortality*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Young Adult

Substances

  • Cyclophosphamide
  • Carboplatin
  • Cisplatin