Intraperitoneal chromic phosphate therapy after second-look laparotomy for ovarian cancer.
Between 1973 and 1985, 118 patients in clinical remission after initial surgery and postoperative chemotherapy for epithelial ovarian carcinoma underwent second-look laparotomy at the University of North Carolina. No evidence of disease (NED) was found in 57 of these patients; 43 patients received 15 mCi of radioactive chromic phosphate (32P) suspension given intraperitoneally in the immediate postoperative period. In 29 other patients, only microscopic or minimal residual disease (nodules less than 2 cm in size) was found, seven received 32P alone, ten received 32P and further chemotherapy, and 12 received chemotherapy alone. The 4-year postsecond-look survival of the patients with NED at second-look was 89% for those receiving 32P and 67% for those who had not. The respective figures for patients with minimal residual disease at second-look are 59% versus 22%. Irrespective of treatment, a group at high risk for failure after negative second-look laparotomy has been identified; those with an initial International Federation of Gynecology and Obstetrics (FIGO) stage greater than I and histologic grade greater than 1. A comparison of our data with 18 previously published series, indicates that use of postsecond-look intraperitoneal 32P can improve the progression-free interval, and possibly overall survival, of patients with NED or minimal residual disease without adding significant complications.
Varia
M
M
Division of Radiation Oncology, University of North Carolina, Chapel Hill 27514.
Rosenman
J
J
Venkatraman
S
S
Askin
F
F
Fowler
W
W
Walton
L
L
Halle
J
J
Currie
J
J
D002277:Carcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002857:Chromium / Q000627:therapeutic use*; D017608:Chromium Compounds; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D007813:Laparotomy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D010710:Phosphates / Q000627:therapeutic use*; D010761:Phosphorus Radioisotopes / Q000627:therapeutic use*; D011379:Prognosis; D012086:Reoperation
D017608:Chromium Compounds; D010710:Phosphates; D010761:Phosphorus Radioisotopes; D002857:Chromium; C509369:chromic phosphate