Outpatient Intraperitoneal Chemotherapy for All Stages of Ovarian, Fallopian Tube, and Peritoneal Cancers: A Pilot Study

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Purpose:The objective of this pilot study was to evaluate a 2-day, outpatient intraperitoneal (I.P.) chemotherapy regimen for all stages of ovarian, fallopian tube, and peritoneal cancers.Methods:All stages were included except low-risk, stage I. The I.P. regimen was the following: day 1, I.P. paclitaxel 60 mg/m2; day 2, I.P. cisplatin 75 mg/m2 plus intravenous (I.V.) paclitaxel at escalating doses. The treatment plan included 3 I.P. cycles for all stages. Optimal stage III was treated with 3 additional cycles of I.V. paclitaxel/carboplatin. Optimal stage IV was treated with 6 additional cycles of I.V. chemotherapy. Stages I grade 3 and IC, and optimal stage II received no further treatment. Follow-up included serial cancer antigen 125 and computer tomographies.Results:From June 1, 2007, to December 31, 2009, 31 patients were accrued. Fourteen patients had stage III disease. Eight of 14 were alive and had no evidence of disease (NED). Three of 14 are alive with disease. Three of 14 died, 2 with progressive disease. Median follow-up for stage III was 28 months. Six patients had stage IV. Four of 6 patients are alive and NED. Two of 6 died with progressive disease. The median follow-up for stage IV was 16 months. Eleven patients had early, high-risk disease. Eleven of 11 patients are alive and NED, with a median follow-up of 21 months. There were no I.P. chemotherapy delays. Grade 3-4 hematologic and nonhematologic toxicities were rare.Conclusion:Preliminary data revealed tolerance of this 2-day outpatient I.P. chemotherapy regimen, with promising response and survival. With continued accrual and follow-up, this I.P. chemotherapy schedule may demonstrate usefulness in all stages of ovarian cancer.

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