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  • Feasibility of a Modified Outpatient Regimen of Intravenous/Intraperitoneal Chemotherapy in Optimally Debulked Stage III Ovarian Cancer Patients: A GEICO Study

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Ovarian Cancer
Feasibility of a Modified Outpatient Regimen of Intravenous/Intraperitoneal Chemotherapy in Optimally Debulked Stage III Ovarian Cancer Patients: A GEICO Study
  1. Ana Oaknin, MD*,
  2. Desamparado Roda, MD†,
  3. Antonio González-Martín, MD‡,
  4. Luis Chiva, MD, PhD‡,
  5. Jesús García-Donas, MD§,
  6. Ana de Juan, MD∥,
  7. Andrés Redondo, MD,
  8. Sergio Martínez, MD, PhD#,
  9. Yolanda García, MD**,
  10. Sílvia Catot, MD††,
  11. Jordi Ponce, MD, PhD‡‡,
  12. J.M. del Campo, MD*,
  13. Andrés Cervantes, MD, PhD† and
  14. Andrés Poveda, MD§§
  1. *Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain;
  2. †Department of Hematology and Medical Oncology, INCLIVA, University of Valencia, Valencia;
  3. ‡Medical Oncology Department, Centro Oncológico MD Anderson International España; and
  4. §Medical Oncology Department, Hospital Universitario Fundacion Alcorcon, Alcorcon, Madrid;
  5. ∥Medical Oncology Department, Marques de Valdecilla University Hospital, Santander;
  6. Medical Oncology Department, La Paz University Hospital, Madrid;
  7. #Gynecologic Oncology Unit, ICGON, Hospital Clínic Barcelona, University of Barcelona;
  8. **Medical Oncology Department, Corporació Sanitària Parc Taulí, Sabadell;
  9. ††Medical Oncology Department, Althaia Xarxa Assitencia de Manresa, Manresa; and
  10. ‡‡University Hospital of Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona; and
  11. §§Oncogynecologic Area,Valencian Institute of Oncology, Valencia, Spain.
  1. Address correspondence and reprint requests to Ana Oaknin, MD, Vall d'Hebron University Hospital, Medical Oncology Department, Gynecologic Oncology Unit, Barcelona, Spain. E-mail: amoaknin{at}vhebron.net.

Abstract

Objectives: The objective of the study was to assess the feasibility, toxicity, and reasons for early discontinuation of a modified outpatient intraperitoneal/intravenous (IP/IV) chemotherapy regimen for the treatment of patients with optimally debulked stage III ovarian cancer.

Methods: Between February 2006 and November 2008, 51 consecutive patients from Institutions of the Spanish Ovarian Cancer Group (GEICO) were treated with a modified outpatient IP chemotherapy regimen. Patients received IV paclitaxel 175 mg/m2 over 3 hours on day 1, followed by IP cisplatin 100 mg/m2 (or 75 mg/m2 according to the principal investigator's criteria) on day 2. On day 8, patients received IP paclitaxel 60 mg/m2. To homogenize the IP administration and supportive measures, a GEICO guideline for IP chemotherapy was established. Patients were treated with the intention to receive 6 courses of chemotherapy every 21 days.

Results: The median age of the patients was 49 years (range, 36-75 years), and most of them had papillary serous ovarian cancer (78%), International Federation of Gynecology and Obstetrics stage IIIC (76%). Thirty-nine patients completed 4 or more IP cycles, and 28 (61%) completed all 6 IP cycles. Twenty-two patients discontinued the IP/IV treatment, mainly because of chemotherapy toxicity (10 patients) and catheter-related complications (5 patients). The most prevalent grade 3/4 toxicities were neutropenia (14 patients; 30%) and gastrointestinal events (12 patients; 26%).

Conclusions: The GEICO outpatient modified regimen resulted in a lesser toxicity and a greater rate of treatment completion than previously reported. The accurate selection of patients and the administration following well-defined guidelines can increase the feasibility of IP chemotherapy administration.

  • Ovarian cancer
  • Cisplatin
  • Paclitaxel
  • Modified chemotherapy regimen

https://doi.org/10.1097/IGC.0b013e31821ee777

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    Footnotes

    • Writing assistance was paid by GEICO.

    • The authors do not have conflicts of interest.