The use of cisplatin plus doxorubicin or paclitaxel in hyperthermic intraperitoneal chemotherapy (HIPEC) for stage IIIC or IV epithelial ovarian cancer: a comparative study

Clin Transl Oncol. 2019 Oct;21(10):1357-1363. doi: 10.1007/s12094-019-02065-3. Epub 2019 Feb 20.

Abstract

Purpose: Our main aim is to analyze the survival results in women operated on for advanced ovarian cancer with two different HIPEC regimens (cisplatin plus doxorubicin versus paclitaxel).

Patients and methods: A prospective cohort of patients with stage IIIC or IV epithelial ovarian cancer operated on with cytoreductive surgery and HIPEC, from October-2008 to February-2016, was retrospectively analyzed. The two drugs used, cisplatin/doxorubicin (Group A) and paclitaxel (Group B), were compared.

Results: Forty-one patients were treated with cytoreductive surgery and HIPEC; 19 patients (46%) were in Group A and 22 (54%) were in Group B. The extent of peritoneal disease was comparable between groups (Peritoneal Cancer Index of 10 in Group A versus PCI of 12.5 in Group B). There were no differences in morbidity between groups, with a severe morbidity (Dindo-Clavien III or IV) of 36.8% versus 27.3%, respectively. There was no postoperative mortality. Median follow-up was 39 months. Median overall survival was 79 months. Overall survival at 3 years in Group A was 66% versus 82.9% in Group B (p = 0.248). Incomplete cytoreduction (macroscopic residual tumour after surgery) was identified as the only independent factor that influenced overall survival (HR 12.30, 95% CI 1.28-118.33, p = 0.03). The cytostatic used in HIPEC had no influence in overall survival.

Conclusion: The cytostatic used in HIPEC did not have a negative effect in the prognosis of patients with advanced ovarian cancer.

Keywords: Chemotherapy; Cytostatic agents; HIPEC; Ovarian cancer; Peritoneal carcinomatosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Ovarian Epithelial / mortality
  • Carcinoma, Ovarian Epithelial / pathology
  • Carcinoma, Ovarian Epithelial / therapy*
  • Cisplatin / administration & dosage
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / methods
  • Cytoreduction Surgical Procedures / adverse effects
  • Cytoreduction Surgical Procedures / statistics & numerical data
  • Doxorubicin / administration & dosage
  • Female
  • Humans
  • Hyperthermia, Induced* / adverse effects
  • Hyperthermia, Induced* / statistics & numerical data
  • Middle Aged
  • Neoplasm, Residual
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / therapy*
  • Paclitaxel / administration & dosage
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / therapy*
  • Prospective Studies
  • Retrospective Studies

Substances

  • Doxorubicin
  • Paclitaxel
  • Cisplatin