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Neoadjuvant chemotherapy prior to intraperitoneal chemotherapy in women with advanced ovarian cancer
The Don & Sybil Harrington Cancer Center/Texas Tech University Health Sciences Center, Amarillo, TX
Intraperitoneal/intravenous (IP/IV) chemotherapy with cisplatin/paclitaxel improves survival of patients with optimally debulked ovarian cancer, at the cost of increased toxicity. Neoadjuvant chemotherapy may reduce surgical morbidity and facilitate debulking. This pilot study evaluated overall survival (OS), progression-free survival (PFS), and morbidity in patients treated with neoadjuvant chemotherapy prior to debulking surgery and subsequent IP/IV chemotherapy. Twenty-four women were identified with presumed stage IIIC/IV ovarian cancer and received 3 cycles of neoadjuvant IV carboplatin/paclitaxel. Four of these patients had disease progression while receiving neoadjuvant chemotherapy and were eliminated from the study. The remaining 20 patients underwent surgery and were optimally debulked. Eighteen of these 20 patients subsequently received 6 cycles of IP/IV cisplatin/paclitaxel chemotherapy. Median PFS was 33 months, and median OS was 49 months. Patients receiving neoadjuvant chemotherapy appeared to tolerate IP/IV chemotherapy well, with a high rate of completion of 6 cycles (95%). Surgical morbidity appeared to decrease with neoadjuvant therapy, which may contribute to the favorable OS in this group.
| Commun Oncol 2008;5:376–380 | full text |  101 kb |