Evaluation of survival after second-line intraperitoneal cisplatin-based chemotherapy for advanced ovarian cancer.
作者信息
Piver M S, Recio F O, Baker T R, Driscoll D
机构信息
Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263.
出版信息
Cancer. 1994 Mar 15;73(6):1693-8. doi: 10.1002/1097-0142(19940315)73:6<1693::aid-cncr2820730623>3.0.co;2-0.
BACKGROUND
The authors sought to evaluate survival of patients with ovarian cancer treated with second-line intraperitoneal cisplatin-based chemotherapy.
METHODS
From August 1985 to September 1991, 63 patients with recurrent or persistent ovarian cancer after first-line cisplatin-based chemotherapy were on a protocol and treated with cisplatin, cytarabine, with or without bleomycin. Eligibility included Stage III/IV invasive adenocarcinoma of the ovary, documentation of the size of residual disease at reoperation, and prior treatment with first-line intravenous cisplatin-based chemotherapy.
RESULTS
The median survival from intraperitoneal chemotherapy was 29 months. For patients who responded to first-line chemotherapy and second-line intraperitoneal chemotherapy, the 5-year survival was 60%, but for patients with response to first-line chemotherapy but no response to intraperitoneal chemotherapy the 5-year survival was only 17%, and no patient survived 5 years who did not have a response to first- or second-line therapy (P < 0.0001). There was significant improvement in the 2-year survival from initiation of intraperitoneal chemotherapy for patients with < or = 5 mm residual tumor in greatest dimension (74%), compared with patients with residual tumor larger than 5 mm and smaller than or equal to 2 cm (38%), and patients with residual tumor larger than 2 cm (0%) (P < 0.0001).
CONCLUSION
Survival was increased for patients who (1) had a response to first-line intravenous chemotherapy and second-line intraperitoneal chemotherapy and (2) who had residual tumor 5 mm or smaller at the initiation of intraperitoneal therapy. The conclusion that the prolonged survival is secondary to cisplatin-based chemotherapy administered intraperitoneally must be made with caution because survival may have been secondary to the small residual disease at initiation of second-line chemotherapy or the systemic effect of cisplatin.
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