[Neoadjuvant chemotherapy with intraperitoneal paclitaxel for advanced gynecologic cancer]

We evaluated safety and activity of intraperitoneal paclitaxel [=PTX (ip)] for neoadjuvant chemotherapy (NAC) of patients with advanced gynecologic cancer.

13 patients with gynecologic cancer who had diffuse peritoneal dissemination received PTX (ip) with systemic chemotherapy (TC regimen) for NAC. After 3-6 courses of NAC, interval debulking surgery (IDS) was done. At IDS, we explored intraperitoneal cavity and debulked as much as possible, and examined pathological effects of NAC.

PTX (ip) was well tolerated with apparent anti-cancer activity. Eleven patients were done with IDS after 3-6 NAC courses. Ten of 11 patients were completed an optimal surgery without extended resections. Eight of 11 patients with IDS had grade 2 (5 cases) or grade 3 (3 cases) effects of pathological examination.

According to this exploratory research, we considered PTX (ip)=80 mg/m2 with PTX (iv)=115 mg/m2 and CBDCA (iv) AUC=4 as an optimum drug dose. Although evaluated in a small number of patients, PTX (ip) appeared to have safety and anti-cancer activity, and should be evaluated further.