Progression-free and overall survival of a modified outpatient regimen of primary intravenous/intraperitoneal paclitaxel and intraperitoneal cisplatin in ovarian, fallopian tube, and primary peritoneal cancer Journal Article

  

Authors:	Barlin, J. N.; Dao, F.; Zgheib, N. B.; Ferguson, S. E.; Sabbatini, P. J.; Hensley, M. L.; Bell-Mcguinn, K. M.; Konner, J.; Tew, W. P.; Aghajanian, C.; Chi, D. S.
Article Title:	Progression-free and overall survival of a modified outpatient regimen of primary intravenous/intraperitoneal paclitaxel and intraperitoneal cisplatin in ovarian, fallopian tube, and primary peritoneal cancer
Abstract:	Objective: GOG study 172 demonstrated improved progression-free (PFS) and overall (OS) survival for patients with stage III optimally debulked ovarian and peritoneal carcinoma treated with IV/IP paclitaxel and IP cisplatin compared to standard IV therapy. The inpatient administration, toxicity profile, and limited completion rate have been blamed for the lack of acceptance and widespread use of this regimen. We sought to evaluate the PFS, OS, toxicity, and completion rate of a modified outpatient IP regimen. Methods: Using a prospectively maintained database, we evaluated the outcomes of patients who underwent primary optimal cytoreduction for stage III ovarian, tubal, or peritoneal carcinoma followed by IV/IP chemotherapy from 1/05-3/09. Our modified regimen was as follows: IV paclitaxel (135 mg/m 2) over 3 h on day 1, IP cisplatin (75 mg/m 2) on day 2, and IP paclitaxel (60 mg/m 2) on day 8, given every 21 days for 6 cycles. Results: We identified 102 patients who initiated the modified IV/IP regimen and completed chemotherapy. The median follow-up was 43 months. The median age at diagnosis was 57 years (range, 23-76). Primary disease site was: ovary, 77 (75%); fallopian tube, 13 (13%); peritoneum, 12 (12%). FIGO stage was: IIIA, 8 (8%); IIIB, 4 (4%); IIIC, 90 (88%). Residual disease after cytoreduction was: none, 58 (57%); ≤ 1 cm, 44 (43%). The most frequent grade 3/4 toxicities were: neutropenia, 12 (12%); gastrointestinal, 8 (8%); neurologic, 6 (6%). Eighty-two (80%) of 102 patients completed 4 or more cycles of IV/IP therapy; 56 (55%) completed all 6 cycles. The median PFS and OS were 29 and 67 months, respectively. Conclusions: By modifying the GOG 172 treatment regimen, convenience, toxicity, and tolerability appear improved, with survival outcomes similar to those of GOG 172. This modified IV/IP regimen warrants further study. © 2012 Elsevier Inc. All rights reserved.
Keywords:	survival; ovarian cancer; intraperitoneal chemotherapy; modified regimen
Journal Title:	Gynecologic Oncology
Volume:	125
Issue:	3
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2012-06-01
Start Page:	621
End Page:	624
Language:	English
DOI:	10.1016/j.ygyno.2012.03.027
PROVIDER:	scopus
PUBMED:	22446622
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84861194164&partnerID=40&md5=d9371158cda07cfa9ffbd6ce8024d0ef
Notes:	--- - "Export Date: 4 June 2012" - "CODEN: GYNOA" - "Source: Scopus"

https://synapse.mskcc.org/synapse/works/has_related_data_chk/28399