title: Second-line Intraperitoneal Platinum-based Therapy Leads to an Increase in Second-line Progression-free Survival for Epithelial Ovarian Cancer.
abstract: OBJECTIVE
  Only 3% of patients with epithelial ovarian cancer (EOC) have a longer treatment-free interval (TFI) after second-line intravenous (IV) platinum chemotherapy than with frontline IV therapy. We sought to examine what impact second-line combination IV/intraperitoneal (IV/IP) platinum therapy might have on the ratio of second-line to first-line TFI in patients treated with second-line IP platinum chemotherapy for first recurrence after front-line IV therapy.
  
  
  METHODS
  A retrospective analysis of women who received combination platinum-based IV/IP chemotherapy for recurrent EOC between January 2005 and March 2011 was conducted. Patients were identified from the tumor registry, and office records from a large gynecologic oncology practice and patient records were reviewed. The first and second TFIs were defined as the time from the end of previous platinum-based therapy to the start of next therapy.
  
  
  RESULTS
  Twenty-five women received IV/IP chemotherapy for their first EOC recurrence after IV chemotherapy. In 10 patients (40%), we observed a longer TFI after IV/IP chemotherapy than after primary IV chemotherapy. For these 10 patients, the median TFI for primary response was 22 months (range, 15-28), whereas median TFI after IV/IP chemotherapy for recurrent disease was 37 months (range, 12-61).
  
  
  CONCLUSIONS
  For EOC patients with limited peritoneal recurrence, 40% of patients had a second-line IP-platinum TFI that exceeded their frontline IV-platinum TFI compared to published data. These data support the use of IV/IP chemotherapy as a treatment for recurrence.
authors.affiliation: *Division of Gynecologic Oncology, Magee-Womens Hospital of UPMC, Pittsburgh, PA; †Mid Atlantic Gynecologic Oncology of Mon General Hospital, Morgantown, WV; ‡Division of Gynecologic Oncology, Hahnemann University Hospital, Philadelphia, PA; §Department of Radiation Oncology, Magee-Womens Hospital of UPMC, Pittsburgh, PA; and ∥Division of Gynecologic Oncology, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Boisen
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Lesnock
authors.forename: Scott D
authors.initials: SD
authors.lastname: Richard
authors.forename: Sushil
authors.initials: S
authors.lastname: Beriwal
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Kelley
authors.forename: Kristin K
authors.initials: KK
authors.lastname: Zorn
authors.forename: Robert P
authors.initials: RP
authors.lastname: Edwards
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007263:Infusions, Parenteral; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D017239:Paclitaxel; D002945:Cisplatin