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Intraperitoneal cisplatin‐based chemotherapy vs. intravenous cisplatin‐based chemotherapy for stage III optimally cytoreduced epithelial ovarian cancer
Author(s) -
Yen M.S.,
Juang C.M.,
Lai C.R.,
Chao G.C.,
Ng H.T.,
Yuan C.C.
Publication year - 2001
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(00)00340-4
Subject(s) - medicine , debulking , hazard ratio , cisplatin , chemotherapy , ovarian cancer , surgery , oncology , confidence interval , urology , gastroenterology , cancer
Objective : To compare the survival between intraperitoneal cisplatin‐based chemotherapy (IPCT) and intravenous cisplatin‐based chemotherapy (IVCT) in stage III epithelial ovarian cancer with minimal residual disease (<1 cm) after primary debulking surgery. Method : One hundred and thirty‐two patients with stage III epithelial ovarian cancer after optimal primary debulking surgery with minimal residual disease between April 1990 and March 1995 were entered into a randomized clinical trial in which IPCT or IVCT was administered at 3‐week intervals. Patients in the IPCT arm received cisplatin‐based (100 mg/m 2 ) intraperitoneal chemotherapy. Patients in the IVCT arm received cisplatin‐based (50 mg/m 2 ) intravenous chemotherapy. The tumor response was assessed every 3 months. The hematological toxicity using the South West Oncology Group (SWOG) toxicity criteria was assessed. Catheter complications associated with intraperitoneal chemotherapy were also analyzed. Result : The estimated median survival in the IPCT group was 43 months (95% confidence interval, 34–54) and IVCT group was 48 months (95% confidence interval, 37–59). The hazard ratio of death was not statistically significant between IPCT and IVCT (hazard ratio, 1.13; 95% CI, 0.69–1.86; P =0.317). The frequencies of hematological toxic effects were significantly lower in the IPCT group than in the IVCT group. Conclusion : Intravenous and intraperitoneal chemotherapy are associated with equivalent survival in patients with minimal residual stage III epithelial ovarian cancer after optimal cytoreductive surgery.