Intraperitoneal hyperthermic chemotherapy in ovarian cancer

Abstract

We investigated the effect of intraperitoneal hyperthermic perfusion chemotherapy as consolidation therapy in stage IIIB–IIIC ovarian cancer, following cytoreductive surgery and systemic chemotherapy (cisplatin–cyclophosphamide—six cycles). Disease-free survival, overall survival, and side effects were compared with a control group of patients who refused a second-look surgery and intraperitoneal chemotherapy. In a multicenter prospective trial, 29 patients with complete or optimal cytoreductive surgery and systemic treatment were included in the consolidation group and received intraperitoneal hyperthermic perfusion chemotherapy. Patients were recruited between January 1991 and December 1997. The intraperitoneal hyperthermic perfusion was performed with open-abdomen technique, using physiologic solution containing cisplatin 100 mg/m2, for 60 min in hyperthermic phase (41–43°C). Intraperitoneal hyperthermic perfusion chemotherapy was locally and systemically well tolerated. The consolidation therapy group showed a better 5-year survival rate and lower recurrent disease rate, but differences were not statistically significant. Our results suggest that intraperitoneal hyperthermic perfusion chemotherapy is a feasible, well-tolerated, and promising alternative as consolidation therapy in ovarian cancer.

Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS) in ovarian cancer: A systematic review and meta-analysis

“…Only one study reached median overall survival for CRS with and without HIPEC (64.4 months and 46.4, respectively). [26] Two studies did not reach median survival for HIPEC+CRS but reached 51 and 72 months for CRS alone [25,27] ( Table 1).…”

“…These results were pooled from three trials, one [26] with only Stage III EOC and two [25,27] [27]). One of these two trials reported survival outcomes separately for Stage III EOC [25].…”

“…The HIPEC chemotherapy used, temperature and duration was described in all 37 studies (eTable 2). The most commonly used HIPEC chemotherapy was cisplatin (CDDP) that was used either alone [26,42,49,50,55], or in combination with other agents such as doxorubicin [36,37,41,45,56], paclitaxel [40] or mitomycin-C [34,57] Figure 1). Only one study reached median overall survival for CRS with and without HIPEC (64.4 months and 46.4, respectively).…”

Treatment of peritoneal carcinomatosis from ovarian cancer. Present, future directions and proposals

“…Gori et al [73] used HIPEC with cisplatin as the consolidation treatment during the 'second-look' laparotomy in patients with advanced ovarian cancer following an optimal cytoreductive surgery and six systemic chemotherapy cycles (cisplatin-cyclophosphamide), showing no statistically significant differences in overall survival. Some phase II and phase III studies have recently been published using different agents such as epidoxorubicin and intraperitoneal administration of yttrium-90-labelled murine HMFG1 (90Y-muHMFG1), respectively, in patients with epithelial ovarian cancer with a negative 'second-look' laparotomy after a primary treatment, showing no differences in overall survival and recurrence-free time [74,75].…”

Intraperitoneal chemotherapy in ovarian cancer

“…Si de nombreux auteurs ont rapporté leur expé rience d'é tude de phase II de chimiohyperthermie intrapé ritoné ale (CHIP), il n'existe aucune étude de phase III dans les cancers de l'ovaire ou dans d'autres tumeurs é valuant spé cifiquement l'apport de la CHIP en supplé ment d'une exé rè se chirurgicale pé ritoné ale [9,38].…”