Experience with platinum-paclitaxel chemotherapy in the initial management of papillary serous carcinoma of the peritoneum.
OBJECTIVE
The objective of this study was to assess the activity and toxicity of combination platinum-paclitaxel chemotherapy in the initial management of patients with papillary serous carcinoma of the peritoneum (PSCP).


METHODS
Patients initially treated at The Cleveland Clinic Foundation (CCF) for PSCP with platinum-paclitaxel combination chemotherapy regimens were identified and clinical information was abstracted by chart review. Toxicity data, progression-free survival, and overall survival were determined.


RESULTS
Thirty-eight patients (36 Stage IIIC and 2 Stage IV) were identified. All chemotherapy was administered as outpatient infusions. All patients received paclitaxel (135 or 175 mg/m2) and 12 received cisplatin and 26 carboplatin. Two hundred thirty-two cycles were administered, with only three (1.3%) episodes of grade 3 toxicity and no grade 4 toxicity. Ninety-two percent of patients experienced at least a 50% reduction in their CA-125 levels and 55% experienced a greater than 90% reduction. Median progression-free survival (Kaplan-Meier) was 15 months and median overall survival was 40 months. Survival for optimally debulked patients (median not yet reached with median follow-up of 24 months) was significantly better than for suboptimally debulked patients (median 32.8 months) (P = 0.012).


CONCLUSIONS
Platinum-paclitaxel chemotherapy regimens have substantial utility in the initial management of PSCP patients. The toxicity profile is modest. Carboplatin or cisplatin in conjunction with paclitaxel is the current first-line recommended chemotherapy for PSCP.
Kennedy
A W
AW
Cleveland Clinic Cancer Center and the Departments of Gynecology/Obstetrics and Hematology/Medical Oncology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio, 44195, USA.
Markman
M
M
Webster
K D
KD
Kulp
B
B
Peterson
G
G
Rybicki
L A
LA
Belinson
J L
JL
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018394:CA-125 Antigen / Q000097:blood; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D018283:Cystadenocarcinoma, Papillary / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000401:mortality
D018394:CA-125 Antigen; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin