Hyperthermic intraperitoneal chemotherapy with carboplatin for optimally-cytoreduced, recurrent, platinum-sensitive ovarian carcinoma: A pilot study

Peter A. Argenta, Thanasak Sueblinvong, Melissa A. Geller, Amy L. Jonson, Levi S. Downs, Linda F. Carson, Joseph J. Ivy, Patricia L. Judson

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26 Scopus citations

Abstract

Objective We aimed to evaluate the feasibility and tolerability of hyperthermic intraperitoneal carboplatin (HIPEC-carboplatin) following secondary cytoreduction for recurrent, platinum-sensitive ovarian cancer. Methods In a single institution prospective, pilot study, ten patients underwent secondary cytoreductive surgery followed by HIPEC-carboplatin at 1000 mg/m2. Consolidation (6 cycles) was with platinum-based regimens. Adverse and quality of life were measured throughout treatment. Results Twelve patients were enrolled of which 2 were excluded (one each for extra-abdominal disease indentified before surgery and suboptimal cytoreduction). All 10 remaining patients received prescribed HIPEC-carboplatin. There were no intra-operative complications or AEs attributable to HIPEC-therapy. Grade 1/2 nausea was the most common post-operative toxicity (6/10 patients). Two patients had grade 4 post-operative neutropenia and thrombocytopenia but only one experienced transient treatment delay. The median hospital stay was 5.5 days. 69/70 (98%) of planned chemotherapy doses were ultimately delivered with 1 patient electively forgoing her final treatment. At a median (range) follow-up of 16 (6-23) months, three patients have recurred at 8, 14, and 16 months from surgery. The median disease-free and overall survivals have not been reached. Fact-O scores were significantly lower following surgery (126 vs. 108, p <.01), but improved by completion of therapy (108 vs. 113, p = 0.27). Conclusions HIPEC-carboplatin at 1000 mg/m2 following optimal cytoreduction for ovarian cancer is feasible. Surgical complications were not observed, and post-operative AEs were largely within expected ranges. Consolidation using standard platinum-based regimens was feasible following HIPEC-carboplatin, and preliminary survival data suggests efficacy. Further investigation of HIPEC-carboplatin in the setting of debulkable cancer recurrence is warranted.

Original languageEnglish (US)
Pages (from-to)81-85
Number of pages5
JournalGynecologic oncology
Volume129
Issue number1
DOIs
StatePublished - Apr 2013

Bibliographical note

Funding Information:
This research was supported by a grant from the Minnesota Ovarian Cancer Alliance .

Funding Information:
The primary endpoint of this pilot trial was to assess feasibility of using HIPEC carboplatin in the setting of optimally cytoreduced, recurrent ovarian cancer. Secondary endpoints included evaluation of toxicity, QoL, time to second cycle of therapy, and progression-free survival. Sample size was predetermined as this study was funded by an unrestricted grant from the Minnesota Ovarian Cancer Alliance which supported the enrollment of 10 patients.

Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.

Keywords

  • Chemotherapy
  • Hyperthermia
  • Hyperthermic chemotherapy
  • Ovarian cancer
  • Secondary cytoreduction

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