Intraperitoneal (IP) chemotherapy with cisplatin demonstrated better prognosis for optimally debulked stage III ovarian cancer. Although, it has not been widely accepted yet due to its complications. On the other hand, intravenous (IV) dose-dense paclitaxel and carboplatin therapy also showed improved survival compared to the conventional paclitaxel and carboplatin for the treatment of advanced ovarian cancer. IP carboplatin was reported to have more reasonable pharmacokinetics than IV carboplatin. The efficacy of IP carboplatin in combination with IV dose-dense paclitaxel for ovarian cancer has not been addressed yet.
We retrospectively analyzed the survival, efficacy and safety of 69 patients with stage II-IV ovarian, fallopian tube, and primary peritoneal carcinoma who underwent IP carboplatin in combination with IV dose-dense paclitaxel (ddTCip) as a frontline chemotherapy.
Eleven and 58 patients underwent optimally and suboptimally debulked surgery, respectively. We observed 91.4% patients had clinical response for ddTCip therapy. Ten and 43 patients showed complete and partial response, respectively. Median follow-up of alive patients was 47 months, median PFS was 19 months, and median OS was 61 months. We observed 89.9%, 55.1% and 20.3% cases had grade 3/4 neutropenia, anemia, and thrombocytopenia, respectively. Port-related adverse events occurred in 8 (11.6%) patients.
We suggest that the frontline chemotherapy with ddTCip therapy is safe and effective even for suboptimally debulked stage II-IV ovarian carcinoma patients. A randomized phase III trial comparing IP versus IV carboplatin in combination with IV dose-dense paclitaxel is currently ongoing.
Clinical trial identification
All authors have declared no conflicts of interest.