title: The feasibility of administering varying high-dose consolidation hyperthermic intraperitoneal chemotherapy with carboplatin in the treatment of ovarian carcinoma.
abstract: OBJECTIVE
  Hyperthermic intraperitoneal chemotherapy (HIPEC) is an intriguing method of delivery wherein the cytotoxic agent is continuously heated and circulated throughout the peritoneum in an attempt to bolster drug efficacy. Despite HIPEC's potential, ascertaining the optimal dose without compromising patient tolerability remains indeterminate.
  
  
  METHODS
  We retrospectively evaluated 52 advanced stage ovarian cancer patients who were treated with consolidation HIPEC with carboplatin at varying doses (e.g., AUC 6, 8 or 10) subsequent to optimal debulking surgery and the attainment of a clinical complete response to their primary chemotherapy regimen. The following patient and operative characteristics were abstracted: demographics, surgery and pathology data, chemotherapy regimen, intraoperative results, toxicity, postoperative complications, length of hospital stay and survival data.
  
  
  RESULTS
  Twelve patients received HIPEC carboplatin at an AUC 6, 15 subjects were treated with carboplatin at an AUC 8 and 25 underwent carboplatin at an AUC 10. There were no intraoperative complications during the administration of HIPEC; mean estimated blood loss was 50 mL and length of hospital stay was 1.65 days. In the overall study population, 5 patients developed grade 3/4 anemia and 33 subjects exhibited grade ≤2 thrombocytopenia and neutropenia. Thirteen patients also developed grade ≤2 nausea on postoperative day 1, which was successfully addressed with anti-emetic therapy; there were no hospital readmissions.
  
  
  CONCLUSIONS
  The results from the current evaluation suggest that consolidation hyperthermic intraperitoneal chemotherapy with carboplatin is both feasible and reasonably tolerated, even at an AUC of 10. However, additional, randomized study of this procedure incorporating chemotherapy dose escalation with a more extensive patient population is warranted.
authors.affiliation: Gynecologic Oncology Associates, 351 Hospital Road, Suite 507, Newport Beach, CA, 92663, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Rettenmaier
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Mendivil
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Abaid
authors.forename: John V
authors.initials: JV
authors.lastname: Brown
authors.forename: John P
authors.initials: JP
authors.lastname: Micha
authors.forename: Amber M
authors.initials: AM
authors.lastname: Wilcox
authors.forename: Bram H
authors.initials: BH
authors.lastname: Goldstein
mesh_terms: D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D016190:Carboplatin