Ip chemotherapy employing a regimen of cisplatin, cytarabine, and bleomycin

Thirty-seven patients with refractory ovarian carcinoma or other malignancies principally confined to the peritoneal cavity were treated with a combination ip chemotherapy regimen consisting of cisplatin (100 or 200 mg/m2), cytarabine (1,200 mg/m2), and bleomycin (15 or 2 U/m2) repeated at 28-day intervals. Sodium thiosulfate was simultaneously administered iv to protect against cisplatin-induced nephrotoxicity. While only one of 18 patients (6%) with bulky residual ovarian carcinoma experienced a partial remission, two of six evaluable patients with minimal residual disease experienced surgically defined complete remissions. Local abdominal pain was often severe with the higher dose of bleomycin and was occasionally a problem with the lower dose schedule. Fever was common (greater than 70% of courses), but was reduced in degree by pretreatment with steroids. We conclude that combination ip chemotherapy with this three-drug regimen can result in objective tumor regressions and surgically defined complete remissions in patients with minimal residual ovarian carcinoma who have failed to achieve a complete remission following cisplatin-based iv chemotherapy.