163 O - Aortic infuslon (ADM, MMC, CDDP) and stop-flow (MMC, ADM) for systemically pretreated and progresslve FLGO III c and IV ovarian cancer-45 patients

Abstract

45 pts. with progressive FIGO III c (36/45 pts) and IV (9/45 pls.) ovarinn Cancer. non reponder to prior systemic chcmotherapy. underwent regional chemotherapy given via high aortic catheter in cycle I and 2 and aortic stop-flow infuion in cycle 3 I)rugs administered were ADM (50 mg). MMC (14 - 20 mg) and CDDP (2 × 50 mg) with upper thigh block in the first two Courses and 20 mg MMC/50 mg ADM in stop-flow infusion. 36/45 pts. (80%) had four-quadrant and 9/45 pts. (20%) had two-quadrant peritoneal carcinosis with severe ascites pts. FIGO IV Showed distant melaslasis to the liver and diaphragm (9/9 pts.) All pts. were resistant to prior systemic chemotherapy and in progression as demanstraled in second-look laparnlomy (33%) or CT-scan (67%) before slart of regional cheniotherapy. Response was estimated according to histology, tumor markers. CT-scan. reduclion of ascites and performance scale Histological response: 3/21 CR(14%); R/21 PR (38%); 7/21 MR (34%); 3/21 NR(14%). Overall clinical response was 91%: 5/45. CR (11%); 21/45 PR (47%): 16/45 MR (35%) tumor markers. (CA l2–5): 6/34 CR (18%): 16/34 PR (47%): 12/34 MR (35%). 14/48 pts. were marker negative. CT-scan: 8/41 CR(19%): 10/41 PR (24%): 13/41 MR (32%): 6/41 NR (15%). 4/41 SI) (10%). Complete resolution of ascitcs occurred in 9/33 pts. (27%). reduction of more than 50% in 14/33 pts. (43%). Performance improved in 27/45 pts. (60%) and remained unchanged in 9/45 pts (20%). Median survival was 12.5 mts. median Lime to progression 8.6 mts. 12/45 pts. are still alive for 37, 36, 36, 31, 30, 28, 21, 20, 18, 17, 12 and 9 mts. side effects consisting of temporary abdominal dicomfort were seldom and usually mild. severe bone marrow depression was never observed. Conclusions : 1 In ovarian cancer response is exposure dependent (Concentralion time) 2 Regional chemotherapy breaks drug resistance in systemically pretreated Ovarian Cancer. 3 Patients gain a substantially improved quality of life and survival benefil from aortic infusional chemotherapy 45 pts. with progressive FIGO III c (36/45 pts) and IV (9/45 pls.) ovarinn Cancer. non reponder to prior systemic chcmotherapy. underwent regional chemotherapy given via high aortic catheter in cycle I and 2 and aortic stop-flow infuion in cycle 3 I)rugs administered were ADM (50 mg). MMC (14 - 20 mg) and CDDP (2 × 50 mg) with upper thigh block in the first two Courses and 20 mg MMC/50 mg ADM in stop-flow infusion. 36/45 pts. (80%) had four-quadrant and 9/45 pts. (20%) had two-quadrant peritoneal carcinosis with severe ascites pts. FIGO IV Showed distant melaslasis to the liver and diaphragm (9/9 pts.) All pts. were resistant to prior systemic chemotherapy and in progression as demanstraled in second-look laparnlomy (33%) or CT-scan (67%) before slart of regional cheniotherapy. Response was estimated according to histology, tumor markers. CT-scan. reduclion of ascites and performance scale Histological response: 3/21 CR(14%); R/21 PR (38%); 7/21 MR (34%); 3/21 NR(14%). Overall clinical response was 91%: 5/45. CR (11%); 21/45 PR (47%): 16/45 MR (35%) tumor markers. (CA l2–5): 6/34 CR (18%): 16/34 PR (47%): 12/34 MR (35%). 14/48 pts. were marker negative. CT-scan: 8/41 CR(19%): 10/41 PR (24%): 13/41 MR (32%): 6/41 NR (15%). 4/41 SI) (10%). Complete resolution of ascitcs occurred in 9/33 pts. (27%). reduction of more than 50% in 14/33 pts. (43%). Performance improved in 27/45 pts. (60%) and remained unchanged in 9/45 pts (20%). Median survival was 12.5 mts. median Lime to progression 8.6 mts. 12/45 pts. are still alive for 37, 36, 36, 31, 30, 28, 21, 20, 18, 17, 12 and 9 mts. side effects consisting of temporary abdominal dicomfort were seldom and usually mild. severe bone marrow depression was never observed. :