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Second-line Intraperitoneal Platinum-based Therapy Leads to an Increase in Second-line Progression-free Survival for Epithelial Ovarian Cancer
  1. Michelle M. Boisen, MD,
  2. Jamie L. Lesnock, MD,
  3. Scott D. Richard, MD,
  4. Sushil Beriwal, MD,
  5. Joseph L. Kelley, MD,
  6. Kristin K. Zorn, MD and
  7. Robert P. Edwards, MD
  1. * Division of Gynecologic Oncology, Magee-Womens Hospital of UPMC, Pittsburgh, PA;
  2. Mid Atlantic Gynecologic Oncology of Mon General Hospital, Morgantown, WV;
  3. Division of Gynecologic Oncology, Hahnemann University Hospital, Philadelphia, PA;
  4. § Department of Radiation Oncology, Magee-Womens Hospital of UPMC, Pittsburgh, PA; and
  5. Division of Gynecologic Oncology, University of Arkansas for Medical Sciences, Little Rock, AR.
  1. Address correspondence and reprint requests to Michelle M. Boisen, MD, Magee-Womens Hospital of UPMC, 300 Halket St, Suite 2130, Pittsburgh, PA 15213. E-mail: boockmeiermm{at}upmc.edu.

Abstract

Objective Only 3% of patients with epithelial ovarian cancer (EOC) have a longer treatment-free interval (TFI) after second-line intravenous (IV) platinum chemotherapy than with frontline IV therapy. We sought to examine what impact second-line combination IV/intraperitoneal (IV/IP) platinum therapy might have on the ratio of second-line to first-line TFI in patients treated with second-line IP platinum chemotherapy for first recurrence after front-line IV therapy.

Methods A retrospective analysis of women who received combination platinum-based IV/IP chemotherapy for recurrent EOC between January 2005 and March 2011 was conducted. Patients were identified from the tumor registry, and office records from a large gynecologic oncology practice and patient records were reviewed. The first and second TFIs were defined as the time from the end of previous platinum-based therapy to the start of next therapy.

Results Twenty-five women received IV/IP chemotherapy for their first EOC recurrence after IV chemotherapy. In 10 patients (40%), we observed a longer TFI after IV/IP chemotherapy than after primary IV chemotherapy. For these 10 patients, the median TFI for primary response was 22 months (range, 15–28), whereas median TFI after IV/IP chemotherapy for recurrent disease was 37 months (range, 12–61).

Conclusions For EOC patients with limited peritoneal recurrence, 40% of patients had a second-line IP-platinum TFI that exceeded their frontline IV-platinum TFI compared to published data. These data support the use of IV/IP chemotherapy as a treatment for recurrence.

  • Ovarian carcinoma
  • Recurrent
  • Intraperitoneal chemotherapy
  • Platinum

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Footnotes

  • The authors declare no conflicts of interest.

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