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

Research output: Contribution to journalArticle

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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 1 2013

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Carboplatin
Platinum
Carcinoma
Drug Therapy
Ovarian Neoplasms
Therapeutics
Neutropenia
Thrombocytopenia
Nausea
Disease-Free Survival
Length of Stay
Quality of Life
Prospective Studies
Recurrence
Survival
Neoplasms

Keywords

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

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Hyperthermic intraperitoneal chemotherapy with carboplatin for optimally-cytoreduced, recurrent, platinum-sensitive ovarian carcinoma : A pilot study. / Argenta, Peter A; Sueblinvong, Thanasak; Geller, Melissa A; Jonson, Amy L.; Downs, Levi S; Carson, Linda F; Ivy, Joseph J.; Judson, Patricia L.

In: Gynecologic oncology, Vol. 129, No. 1, 01.04.2013, p. 81-85.

Research output: Contribution to journalArticle

Argenta, Peter A ; Sueblinvong, Thanasak ; Geller, Melissa A ; Jonson, Amy L. ; Downs, Levi S ; Carson, Linda F ; Ivy, Joseph J. ; Judson, Patricia L. / Hyperthermic intraperitoneal chemotherapy with carboplatin for optimally-cytoreduced, recurrent, platinum-sensitive ovarian carcinoma : A pilot study. In: Gynecologic oncology. 2013 ; Vol. 129, No. 1. pp. 81-85.
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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.",
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T1 - Hyperthermic intraperitoneal chemotherapy with carboplatin for optimally-cytoreduced, recurrent, platinum-sensitive ovarian carcinoma

T2 - A pilot study

AU - Argenta, Peter A

AU - Sueblinvong, Thanasak

AU - Geller, Melissa A

AU - Jonson, Amy L.

AU - Downs, Levi S

AU - Carson, Linda F

AU - Ivy, Joseph J.

AU - Judson, Patricia L.

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N2 - 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.

AB - 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.

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KW - Ovarian cancer

KW - Secondary cytoreduction

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