Phase II study of intraperitoneal cisplatin plus systemic etoposide as second-line treatment in patients with small volume residual ovarian cancer.
The efficacy and toxicity of intraperitoneal (i.p.) cisplatin plus systemic etoposide were studied in 36 patients with small (< 2 cm) residual i.p. ovarian cancer after achieving a partial response to platinum-based, first-line chemotherapy. Treatment comprised 90 mg/m2 i.p. cisplatin with intravenous (i.v.) sodium thiosulphate (day 1) and 600-800 mg/m2 i.v. etoposide (days 1 and 2), every 4 weeks for four to six cycles. 7 patients achieved a pathological complete response (pCR), one a pathological partial response and 16 were clinically stable without evidence of disease. After a median follow-up of 13 months, the median progression-free survival (PFS) was 11 months (95% confidence interval 7-16 months). The actuarial PFS at 24 months is 22% (95% confidence interval 8-36%). Three of six relapses after achieving a pCR (50%) were sited i.p., and 9 of 14 other patients with disease progression (64%) had an i.p. relapse, indicating insufficient local efficacy. There was no renal toxicity, but grade 3-4 leucopenia occurred in 63% and grade 3-4 thrombocytopenia in 8% of cycles, while nausea, vomiting and complete alopecia were common. Although side-effects were acceptable, the efficacy of treatment with i.p. cisplatin plus i.v. etoposide is limited.
de Jong
R S
RS
Department of Medical Oncology, University Hospital, Groningen, The Netherlands.
Willemse
P H
PH
Boonstra
H
H
de Vries
E G
EG
van der Graaf
W T
WT
Sleijfer
D T
DT
van der Zee
A G
AG
Mulder
N H
NH
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage*; D018572:Disease-Free Survival; D004359:Drug Therapy, Combination; D005047:Etoposide / Q000008:administration & dosage*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000188:drug therapy; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D010529:Peritoneal Cavity; D015996:Survival Rate; D013885:Thiosulfates / Q000008:administration & dosage
D000975:Antioxidants; D013885:Thiosulfates; D005047:Etoposide; C017717:sodium thiosulfate; D002945:Cisplatin