Treatment of ovarian cancer with paclitaxel- or carboplatin-based intraperitoneal hyperthermic chemotherapy during secondary surgery

Objective. We aimed to evaluate the efficacy and feasibility of treating advanced ovarian cancer with paclitaxel or carboplatin in intraperitoneal hyperthermic chemotherapy (IPHC) during secondary surgery. Methods. We reviewed clinical data of 96 eligible patients with stage Ic-Ille epithelial ovarian cancer. After primary staging operation and 612 cycles of adjuvant chemotherapy, 22 patients were treated with IPHC-paclitaxel (175 mg/m(2)) and 45 patients were treated with IPHC-carboplatin (350 mg/m(2)) during secondary surgery. Survival rates were compared with those of 29 patients treated with only conventional therapy (control group). Results. In stage III diseases, 5-year survival rates were 84.6% in IPHC-paclitaxel, 63.0% in IPHC-carboplatin (P=0.4098) and 32.8% in control group (vs. IPHC, P=0.0003). Three-year progression-free survival rates in stage III diseases were both 56.3% in IPHC-paclitaxel and IPHC-carboplatin (P=0.8911) and 16.7% in control group (vs. IPHC, P = 0.0028). For the relative risk of disease progression yielded from multivariate analyses, hazard ratio of IPHC-paclitaxel was 0.281 (P=0.0039) and that of IPHC-carboplatin was 0.443 (P=0.0083). Like carboplatin (hazard ratio: 0.396, P=0.0004), IPHC-paclitaxel considerably decreased the risk of death (hazard ratio: 0.197, P=0.0253). Conclusion. In advanced ovarian cancer, IPHC using paclitaxel or carboplatin during secondary surgery Could be a candidate for regional consolidation therapy to prolong survival and hinder disease progression. (c) 2007 Elsevier Inc. All rights reserved.