nach oben

Erschienen in:

01.07.2017 | Original Article

Consolidation hyperthermic intraperitoneal chemotherapy for the treatment of advanced stage ovarian carcinoma: a 3 year experience

verfasst von: Alberto A. Mendivil, Mark A. Rettenmaier, Lisa N. Abaid, John V. Brown III, Kristina M. Mori, Katrina L. Lopez, Bram H. Goldstein

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Hyperthermic intraperitoneal chemotherapy (HIPEC) potentially confers significant survival benefits in the management of ovarian cancer although the long-term data remain scant. We sought to compare the survival rates of advanced stage ovarian cancer patients who were treated with primary induction therapy alone or in conjunction with consolidation HIPEC.

Methods

69 ovarian cancer patients who underwent surgery and completed their primary induction chemotherapy were treated with consolidation carboplatin (AUC 10) based HIPEC and compared to a historical cohort that received surgery and primary chemotherapy alone (n = 69). The demographic and clinical characteristics on which we were primarily focused, included patient age, body mass index, surgery and pathology data, chemotherapy regimen, toxicity, and progression free/overall survival.

Results

The two patient groups’ demographic and clinical characteristics were similar (P > 0.05). Progression-free survival was significantly more pronounced in the HIPEC (25.1 months) patients compared to the control group (20 months) (P = 0.024) and there was a decreased risk of disease progression accorded to the patients treated with HIPEC (HR 2.1028; 95% CI 1.2941–3.4167; P = 0.0027). However, we did not discern any HIPEC related overall survival advantages (P = 0.29).

Conclusions

The results from our ovarian cancer study suggest that adjunctive HIPEC proffers a significant progression-free survival advantage and a decreased risk for disease progression. There was, however, no overall survival advantage discerned by the HIPEC group. We also recognize that HIPEC remains controversial, and thus randomized studies evaluating HIPEC compared to standard chemotherapy in the management of ovarian cancer are warranted.

Siegel RL, Miller KD, Jemal A (2015) Cancer statistics, 2015. CA Cancer J Clin 65:5–29CrossRefPubMed

Vasey PA, Jayson GC, Gordon A et al (2004) Phase III randomized trial of docetaxel-carboplatin versus paclitaxel-carboplatin as first-line chemotherapy for ovarian carcinoma. J Natl Cancer Inst 96:1682–1691CrossRefPubMed

Abaid LN, Micha JP, Rettenmaier MA, Brown JV, Mendivil AA, Lopez KL, Goldstein BH (2013) A phase II study of modified dose-dense paclitaxel and every 4-week carboplatin for the treatment of advanced-stage primary epithelial ovarian, fallopian tube, or peritoneal carcinoma. Cancer Chemother Pharmacol 72:101–107CrossRefPubMed

Gonzalez Bayon L, Steiner MA, Vasquez Jimenez W, Asencio JM, Alvarez de Sierra P, Atahualpa Arenas F et al (2013) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for the treatment of advanced epithelial ovarian carcinoma: upfront therapy, at first recurrence, or later? Eur J Surg Oncol 39:109–115CrossRef

Gourley C, Walker JL, Mackay HJ (2016) Update on intraperitoneal chemotherapy for the treatment of epithelial ovarian cancer. Am Soc Clin Oncol Educ Book 35:143–151CrossRefPubMed

Los G, van Vugt MJ, Pinedo HM (1994) Response of peritoneal solid tumours after intraperitoneal chemohyperthermia treatment with cisplatin or carboplatin. Br J Cancer 69:235–241CrossRefPubMedPubMedCentral

Tentes AA, Kakolyris S, Kyziridis D (2012) Cytoreductive surgery combined with hyperthermic intraperitoneal intraoperative chemotherapy in the treatment of advanced epithelial ovarian cancer. J Oncol 2012:358341CrossRefPubMedPubMedCentral

Rettenmaier MA, Mendivil AA, Abaid LN, Brown Iii JV, Wilcox AM, Goldstein BH (2015) Consolidation hyperthermic intraperitoneal chemotherapy and maintenance chemotherapy following laparoscopic cytoreductive surgery in the treatment of ovarian carcinoma. Int J Hyperth 31:8–14CrossRef

Pomel C, Ferron G, Lorimier G et al (2010) Hyperthermic intra-peritoneal chemotherapy using oxaliplatin as consolidation therapy for advanced epithelial ovarian carcinoma. Results of a phase II prospective multicentre trial. CHIPOVAC study. Eur J Surg Oncol 36:589–593CrossRefPubMed

10.

Eisenhauer EL, Abu-Rustum NR, Sonoda Y et al (2008) The effect of maximal surgical cytoreduction on sensitivity to platinum-taxane chemotherapy and subsequent survival in patients with advanced ovarian cancer. Gynecol Oncol 108:276–281CrossRefPubMed

11.

Rettenmaier MA, Abaid LN, Erwin MR et al (2009) A retrospective review of the GelPort system in single-port access pelvic surgery. J Minim Invasive Gynecol 16:743–747CrossRefPubMed

12.

Calvert AH, Newell DR, Gunbrell LA et al (1989) Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol 7:1748–1756CrossRefPubMed

13.

National Institutes of Health, National Cancer Center Institute (2010) CTCAE: common terminology criteria for adverse events, version 4.03

14.

NCI Clinical Alert (2011) Available online at www.nlm.nih.gov/databases/alerts/ovarian_ip_chemo.html. Accessed 27 April 2011

15.

Wenzel LB, Huang HQ, Armstrong DK et al (2007) Health-related quality of life during and after intraperitoneal versus intravenous chemotherapy for optimally debulked ovarian cancer: a Gynecologic Oncology Group Study. J Clin Oncol 25:437CrossRefPubMed

16.

Ansaloni L, Agnoletti V, Amadori A, Catena F, Cavaliere D, Coccolini F et al (2012) Evaluation of extensive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced epithelial ovarian cancer. Int J Gynecol Cancer 22:778–785CrossRefPubMed

17.

McGuire WP, Hoskin WJ, Brady MF et al (1996) Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and IV EOC. N Engl J Med 334:1–6CrossRefPubMed

18.

Dharmadhikari N, Shah R, Jagannath P (2004) Initial experience with hyperthermic intra peritoneal chemotherapy and cytoreductive surgery. Indian J Cancer 51:189–192

19.

Ryu KS, Kim JH, Ko HS et al (2004) Effects of intraperitoneal hyperthermic chemotherapy in ovarian cancer. Gynecol Oncol 2004(94):325–332CrossRef

20.

Sun JH, Ji ZH, Peng KW, Wu HT, Zhang Q, Yonemura Y, Li Y (2016) Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy for the treatment of primary peritoneal serous carcinoma: results of a Chinese retrospective study. Int J Hyperth 32:289–297CrossRef

21.

Kim JH, Lee JM, Ryu KS, Lee YS, Park YG, Hur SY et al (2010) Consolidation hyperthermic intraperitoneal chemotherapy using paclitaxel in patients with epithelial ovarian cancer. J Surg Oncol 101:149–155PubMed

Titel: Consolidation hyperthermic intraperitoneal chemotherapy for the treatment of advanced stage ovarian carcinoma: a 3 year experience
verfasst von: Alberto A. Mendivil
Mark A. Rettenmaier
Lisa N. Abaid
John V. Brown III
Kristina M. Mori
Katrina L. Lopez
Bram H. Goldstein
Publikationsdatum: 01.07.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Cancer Chemotherapy and Pharmacology / Ausgabe 2/2017
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-017-3376-8

Springer Medizin

Consolidation hyperthermic intraperitoneal chemotherapy for the treatment of advanced stage ovarian carcinoma: a 3 year experience