Combination Intraperitoneal Carboplatin and Intravenous and Intraperitoneal Paclitaxel in the Management of Advanced-Stage Ovarian Cancer

Abstract

INTRODUCTION: Intraperitoneal (IP) chemotherapy is known to be effective after optimal primary debulking surgery for ovarian cancer. We conducted a pilot study to investigate a regimen of combination IP carboplatin and intravenous (IV) and IP paclitaxel. METHODS: A prospectively maintained database was used to identify all patients who received IP and IV chemotherapy after an optimal cytoreductive surgery for advanced epithelial ovarian carcinoma from May 2007 to June 2013. The regimen consisted of day 1 administration of IP carboplatin AUC 6 and IV paclitaxel 175 mg/m2 over 3 hours and day 8 IP paclitaxel 60 mg/m2 over 1 hour. Common toxicity criteria for adverse events were used to classify toxicities. Protocol toxicities and oncologic outcomes were recorded. RESULTS: Twenty patients received the treatment protocol. The median age was 62 years (range 42–88 years). The median CA-125 at presentation was 296 units/mL (range 31–4,838 units/mL). Nineteen (95%) patients were stage IIIC. The median number of IP cycles completed was six (range five to six cycles). Grade 3 and 4 toxicities occurred in 11 (55%) and 10 (50%) patients, respectively. The following grade 3 and 4 toxicities occurred: neutropenia in 14 (70%) patients, thrombocytopenia in five (25%), anemia in four (20%), nausea in two (10%), and fatigue in one (5%). With a median follow-up of 20 months, the median progression-free survival has not yet been met. The 5-year overall survival rate was 80%. CONCLUSIONS: Combination day 1 IP carboplatin, IV paclitaxel, and day 8 IP paclitaxel after optimal cytoreductive surgery for advanced-stage epithelial ovarian cancer is effective and safe.