Second line platinum-based intraperitoneal chemotherapy for advanced ovarian cancer

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/m2 cisplatin, or carboplatin AUC 6 intraperitoneally and cyclophosphamide 750 mg/m2 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.