Blogger's Note: abstract does not detail followup period eg. PFS
Abstract
OBJECTIVES:
Randomized controlled trials (RCTs) in optimally cytoreduced epithelial
ovarian cancer
(EOC) patients have demonstrated an impressive survival benefit of
intraperitoneal (IP) platinum over intravenous (IV), but its use has
been limited by significant toxicity from cisplatin. The aim of this
study was to
compare the toxicity and tolerability of IP cisplatin to IP
carboplatin in women with optimally cytoreduced EOC.
METHODS:
Retrospective
analysis of 141 women with EOC who underwent optimal surgical
cytoreduction followed by
IV paclitaxel and IP cisplatin or IP
carboplatin was performed.
Toxicities of the two treatment regimens were
compared. As a
secondary outcome, overall survival (OS) and
progression-free survival (PFS) probabilities were obtained using the
Kaplan-Meier estimate; the log-rank test was used to compare survival
curves.
RESULTS:
Of
the 141 patients, 77 (54.6%) received IP cisplatin and 64 (45.4%)
received IP carboplatin. Eighty-six percent received at least 4cycles of
IP chemotherapy. IP cisplatin was associated with significantly more
grade 3 nausea and vomiting (10.4% vs 1.6%, p=0.033), grade 3 neuropathy
(7.8% vs 0%, p=0.013) and grade 2-3 neutropenia (22.1% vs 9.4%,
p=0.042).
No difference in PFS (p=0.602) or OS (p=0.107) was found
between the groups.
CONCLUSION:
IP
chemotherapy had a high completion rate in both groups of patients. IP
carboplatin required a less resource intense protocol and was tolerated
better than IP cisplatin with less gastrointestinal, neurologic and
hematologic toxicities.
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