1. Hyperthermic intraperitoneal chemotherapy with carboplatin for optimally-cytoreduced, recurrent, platinum-sensitive ovarian carcinoma: A pilot study
- Author
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Levi S. Downs, Melissa A. Geller, Patricia L. Judson, Thanasak Sueblinvong, Amy L. Jonson, Joseph J. Ivy, Linda F. Carson, and Peter A. Argenta
- Subjects
Oncology ,medicine.medical_specialty ,endocrine system diseases ,Nausea ,medicine.medical_treatment ,Antineoplastic Agents ,Pilot Projects ,Neutropenia ,Carboplatin ,chemistry.chemical_compound ,Ovarian carcinoma ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Aged ,Ovarian Neoplasms ,Chemotherapy ,business.industry ,Obstetrics and Gynecology ,Hyperthermia, Induced ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Surgery ,Tolerability ,chemistry ,Female ,Hyperthermic intraperitoneal chemotherapy ,Neoplasm Recurrence, Local ,medicine.symptom ,Ovarian cancer ,business ,Injections, Intraperitoneal - Abstract
We aimed to evaluate the feasibility and tolerability of hyperthermic intraperitoneal carboplatin (HIPEC-carboplatin) following secondary cytoreduction for recurrent, platinum-sensitive ovarian cancer.In a single institution prospective, pilot study, ten patients underwent secondary cytoreductive surgery followed by HIPEC-carboplatin at 1000 mg/m(2). Consolidation (6 cycles) was with platinum-based regimens. Adverse and quality of life were measured throughout treatment.Twelve patients were enrolled of which 2 were excluded (one each for extra-abdominal disease indentified before surgery and suboptimal cytoreduction). All 10 remaining patients received prescribed HIPEC-carboplatin. There were no intra-operative complications or AEs attributable to HIPEC-therapy. Grade 1/2 nausea was the most common post-operative toxicity (6/10 patients). Two patients had grade 4 post-operative neutropenia and thrombocytopenia but only one experienced transient treatment delay. The median hospital stay was 5.5 days. 69/70 (98%) of planned chemotherapy doses were ultimately delivered with 1 patient electively forgoing her final treatment. At a median (range) follow-up of 16 (6-23) months, three patients have recurred at 8, 14, and 16 months from surgery. The median disease-free and overall survivals have not been reached. Fact-O scores were significantly lower following surgery (126 vs. 108, p.01), but improved by completion of therapy (108 vs. 113, p=0.27).HIPEC-carboplatin at 1000 mg/m(2) following optimal cytoreduction for ovarian cancer is feasible. Surgical complications were not observed, and post-operative AEs were largely within expected ranges. Consolidation using standard platinum-based regimens was feasible following HIPEC-carboplatin, and preliminary survival data suggests efficacy. Further investigation of HIPEC-carboplatin in the setting of debulkable cancer recurrence is warranted.
- Published
- 2013