Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: an intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG.

PURPOSE: Most patients with advanced ovarian cancer develop recurrent disease. For those patients who recur at least 6 months after initial therapy, paclitaxel platinum has shown a modest survival advantage over platinum without paclitaxel; however, many patients develop clinically relevant neurotoxicity, frequently resulting in treatment discontinuation. Thus, an alternative regimen without significant neurotoxicity was evaluated by comparing gemcitabine plus carboplatin with single-agent carboplatin in platinum-sensitive recurrent ovarian cancer patients. METHODS: Patients with platinum-sensitive recurrent ovarian cancer were randomly assigned to receive either gemcitabine plus carboplatin or carboplatin alone, every 21 days. The primary objective was to compare progression-free survival (PFS). RESULTS: Three hundred fifty-six patients (178 gemcitabine plus carboplatin; 178 carboplatin) were randomly assigned. Patients received a median of six cycles in both arms. With a median follow-up of 17 months, median PFS was 8.6 months (95% CI, 7.9 to 9.7 months) for gemcitabine plus carboplatin and 5.8 months (95% CI, 5.2 to 7.1 months) for carboplatin. The hazard ration (HR) for PFS was 0.72 (95% CI, 0.58 to 0.90; P = .0031). Response rate was 47.2% (95% CI, 39.9% to 54.5%) for gemcitabine plus carboplatin and 30.9% (95% CI, 24.1% to 37.7%) for carboplatin (P = .0016). The HR for overall survival was 0.96 (95% CI, 0.75 to1.23; P = .7349). While myelosuppression was significantly more common in the combination, sequelae such as febrile neutropenia or infections were uncommon. No statistically significant differences in quality of life scores between arms were noted. CONCLUSION: Gemcitabine plus carboplatin significantly improves PFS and response rate without worsening quality of life for patients with platinum-sensitive recurrent ovarian cancer.

[Laboratory investigation of flow characteristics during intraperitoneal hyperthermic perfusion chemotherapy]. / Laboratoryjne badania dynamiki przeplywu jako element dootrzewnowej perfuzyjnej chemioterapii w hipertermii.

OBJECTIVES: Intraperitoneal hyperthermic perfusion chemotherapy (IPCH) is a complex method used for the treatment of the ovarian cancer. During the procedure, chemotherapeutic agent is administrated into the peritoneal cavity using continuous perfusion and hyperthermic conditions. DESIGN: This experiment was performed to simulate the main features of IPCH and to determine the hydrodynamic characteristics of this method in the laboratory conditions. MATERIALS AND METHODS: The model was made in a natural scale, regarding the anatomical proportions. In order to establish the dispersive properties of the model we determined the distribution of the tracer as a function of the drains' location and intensity of flow. RESULTS AND CONCLUSIONS: The important practical conclusion of the study is that the most advantageous variant is 'slanted' location of inflow and outflow drains. It is also possible to confirm that the hydrodynamic features applied during IPCH enable adequate drug distribution in the peritoneal cavity. The employed location of drains could be reconsider including the possibility of introducing cyclic flow direction alteration (increasing the dispersive properties of the system). We would like thank the Department of Cardiacthoracic Surgery, Rigshospitalet, Copenhagen, Denmark for lending the peristaltic pump.

[Intraperitoneal hyperthermic perfusion chemotherapy in recurrent ovarian cancer]. / Dootrzewnowa hypertermiczna perfuzyjna chemioterapia (IPHC) w przetrwalym raku jajnika--doniesienie wstepne.

The paper presents a treatment of peritoneal spread of ovarian cancer with intraperitoneal hyperthermic perfusion chemotherapy. Hyperthermic antiblastic perfusion was carried out throughout the abdomino-pelvic cavity for 90 min, at the temperature of 41-42 degrees C, with cisplatin (50 mg/l). Perfusion was performed with 4 liters of Maxwell liquid. The perfusion rate was 1200-2000 ml/min. There was no complication during and after procedure.