A Comparison of Intravenous versus Intraperitoneal Chemotherapy for the Initial Treatment of Ovarian Cancer

A phase III study was conducted comparing intraperitoneal (ip) versus intravenous (iv) cisplatin-based therapy for patients with newly diagnosed ovarian cancer to determine if the pharmacologic advantage of ip delivery could be translated into an improved response and survival rate. Twenty-nine pati...

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Veröffentlicht in:Gynecologic oncology 1994-09, Vol.54 (3), p.338-344
Hauptverfasser: Kirmani, Saeeda, Braly, Patricia S., McClay, Edward F., Saltztein, Sidney L., Plaxe, Steven C., Kim, Sinil, Cates, Charles, Howell, Stephen B.
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Sprache:eng
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Zusammenfassung:A phase III study was conducted comparing intraperitoneal (ip) versus intravenous (iv) cisplatin-based therapy for patients with newly diagnosed ovarian cancer to determine if the pharmacologic advantage of ip delivery could be translated into an improved response and survival rate. Twenty-nine patients were randomized to receive six cycles of ip cisplatin 200 mg/m 2 plus ip etoposide 350 mg/m 2 with iv thiosulfate protection given every 4 weeks; thirty-three patients were randomized to receive six cycles of iv cisplatin 100 mg/m 2 plus iv cyclophosphamide 600 mg/m 2 administered every 3 weeks. Patients were stratified by stage (IIC-IV) and size of residual disease (> or ⩽1 cm). The study was conducted in a community-wide setting. The complete response in evaluable patients was 48% in the ip group and 52% in the iv group. The surgical complete response rate for all patients on study, underestimated because not all patients in complete clinical remission had a second-took laparotomy, was 31% in the ip group and 33% in the iv group. There was no difference in the response rates between the treatment arms as a function of residual disease < or >1 cm. With a median follow-up of 46 months (range 21-70 months) there is no difference in response duration or survival. Both regimens were well tolerated with comparable hematologic and nonhematologic toxicity.
ISSN:0090-8258
1095-6859
DOI:10.1006/gyno.1994.1220