Objective: The objective of this study was to assess the activity and toxicity of combination platinum-paclitaxel chemotherapy in the initial management of patients with papillary serous carcinoma of the peritoneum (PSCP).
Methods: Patients initially treated at The Cleveland Clinic Foundation (CCF) for PSCP with platinum-paclitaxel combination chemotherapy regimens were identified and clinical information was abstracted by chart review. Toxicity data, progression-free survival, and overall survival were determined.
Results: Thirty-eight patients (36 Stage IIIC and 2 Stage IV) were identified. All chemotherapy was administered as outpatient infusions. All patients received paclitaxel (135 or 175 mg/m2) and 12 received cisplatin and 26 carboplatin. Two hundred thirty-two cycles were administered, with only three (1.3%) episodes of grade 3 toxicity and no grade 4 toxicity. Ninety-two percent of patients experienced at least a 50% reduction in their CA-125 levels and 55% experienced a greater than 90% reduction. Median progression-free survival (Kaplan-Meier) was 15 months and median overall survival was 40 months. Survival for optimally debulked patients (median not yet reached with median follow-up of 24 months) was significantly better than for suboptimally debulked patients (median 32.8 months) (P = 0.012).
Conclusion: Platinum-paclitaxel chemotherapy regimens have substantial utility in the initial management of PSCP patients. The toxicity profile is modest. Carboplatin or cisplatin in conjunction with paclitaxel is the current first-line recommended chemotherapy for PSCP.
Copyright 1998 Academic Press.