Hyperthermic intraperitoneal chemotherapy with cisplatin and paclitaxel in advanced ovarian cancer: a multicenter prospective observational study

Abstract

ObjectiveCytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been recently reported with favorable oncological outcomes as treatment of advanced epithelial ovarian cancer (EOC). The aim of this study was to demonstrate the feasibility of CRS+HIPEC with cisplatin and paclitaxel for the treatment of advanced EOC.MethodsThis is a prospective observational study of 54 patients, from April 2007 to October 2013, with primary or recurrent peritoneal carcinomatosis due to EOC. The mean age was 54.51±9.34. Thirty patients (59%) had primary EOC, and 24 patients (41%) had recurrent disease.ResultsMean peritoneal cancer index was 10.11 (range, 0 to 28), complete cytoreduction (CC0) was achieved for 47 patients (87%), CC1 for seven patients (13%). Patients with suboptimal cytoreduction (CC2 and CC3) were not included in the study. The mean stay in intensive care unit was 4.73±5.51 days and the mean hospitalization time was 24.0±10.03 days. We did not observe any intraoperative death. Seven patients (13%) required additional operations. Three patients (5.6%) died within 30 days from the procedure. Severe complications were seen in 19 patients (35.2%). During the follow-up period, disease recurred in 33 patients (61.1%); the median disease-free survival time was 12.46 months and the median overall survival time was 32.91 months.ConclusionCRS+HIPEC with cisplatin and paclitaxel for advanced EOC is feasible with acceptable morbidity and mortality. Additional follow-up and further studies are needed to determine the effects of HIPEC on long term survival.

1stEvidence-based Italian Consensus Conference on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Ovarian Cancer

“…Among these, 499 patients from 8 studies have homogenous clinical characteristics and represent the most homogenous population, on which conclusions can be drawn with a higher level of interest. In this population, the median overall survival is 37.3 months (range 27-78), the median disease-free survival is 14.4 months (range [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], and the median 5-year overall survival is 40% (range .…”

Effects of hyperthermia as a mitigation strategy in DNA damage-based cancer therapies

“…Furthermore, hyperthermia combined with several chemotherapeutic agents has been the subject of numerous phase II and III clinical trials. For instance, a recent clinical trial involved the application of a treatment protocol based on hyperthermia combined with cisplatin and paclitaxel for treating advanced ovarian cancer [115]. Another example of an adjuvant hyperthermia therapeutic protocol included treatment with etoposide, ifosfamide and doxorubicin for treating soft tissue sarcoma [116].…”

Hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant chemotherapy as prophylaxis of peritoneal carcinosis from advanced gastric cancer—effects on overall and disease free survival

“…It has been investigated by previous studies (38). The association of cisplatin and paclitaxel in hyperthermic IPC has been previously described in ovarian cancer (16,17). It demonstrated to not increase the morbidity and the two molecules do not impair each other penetration and effects (18).…”

“…No previous reports about the combined use of cisplatin and paclitaxel in hyperthermic regimen exist in AGC. The combination of cisplatin and paclitaxel has been previously described in the management of ovarian cancer (16,17) with good data about its penetration in hyperthermic administration (18).…”