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Abstract
Objective
We
aimed to evaluate the feasibility and tolerability of hyperthermic
intraperitoneal carboplatin (HIPEC-carboplatin) following secondary
cytoreduction for recurrent, platinum-sensitive ovarian cancer.
Methods
In
a single institution prospective, pilot study, ten patients underwent
secondary cytoreductive surgery followed by HIPEC-carboplatin at
1000 mg/m2. Consolidation (6 cycles) was with platinum-based regimens. Adverse and quality of life were measured throughout treatment.
Results
Twelve
patients were enrolled of which 2 were excluded (one each for
extra-abdominal disease indentified before surgery and suboptimal
cytoreduction). All 10 remaining patients received prescribed
HIPEC-carboplatin. There were no intra-operative complications or AEs
attributable to HIPEC-therapy. Grade 1/2 nausea was the most common
post-operative toxicity (6/10 patients). Two patients had grade 4
post-operative neutropenia and thrombocytopenia but only one experienced
transient treatment delay. The median hospital stay was 5.5 days. 69/70
(98%) of planned chemotherapy doses were ultimately delivered with 1
patient electively forgoing her final treatment. At a median (range)
follow-up of 16 (6–23) months, three patients have recurred at 8, 14,
and 16 months from surgery. The median disease-free and overall
survivals have not been reached. Fact-O scores were significantly lower
following surgery (126 vs. 108, p < .01), but improved by completion
of therapy (108 vs. 113, p = 0.27).
Conclusions
HIPEC-carboplatin at 1000 mg/m2
following optimal cytoreduction for ovarian cancer is feasible.
Surgical complications were not observed, and post-operative AEs were
largely within expected ranges. Consolidation using standard
platinum-based regimens was feasible following HIPEC-carboplatin, and
preliminary survival data suggests efficacy. Further investigation of
HIPEC-carboplatin in the setting of debulkable cancer recurrence is
warranted.
Highlights
►
Hyperthermic intraperitoneal carboplatin in the setting of optimal
secondary cytoreduction surgery is feasible.
► Patients receiving hyperthermic intraperitoneal carboplatin were able to tolerate subsequent consolidation therapy.
► Patients receiving hyperthermic intraperitoneal carboplatin were able to tolerate subsequent consolidation therapy.
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