Interval Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in First-Line Treatment for Advanced
Véronique D'Hondt1, Frédéric Goffin, Lise Roca
1*Department of Medical Oncology, Institut Jules Bordet, Brussels, Belgium; †Department of Surgical Oncology, Hôpital de la Citadelle, Liège, Belgium; ‡Biometrics Unit, Institut régional du Cancer de Montpellier (ICM), Montpellier, France; §Department of Medical Oncology, Hôpital de la Citadelle, Liège, Belgium; ∥Clinical Research Unit, Institut Jules Bordet, Brussels, Belgium; ¶Clinical Research Unit, Institut régional du Cancer de Montpellier (ICM), Montpellier, France; and #Department of Surgical Oncology, Institut Jules Bordet, Brussels, Belgium.
Objectives:
We conducted a phase 2 trial to assess the feasibility of interval cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin in patients with stage III and IV pleural ovarian carcinoma in first-line treatment with no macroscopic residual disease after surgery.
Methods:
Patients could be treated either with primary CS with HIPEC followed by 6 conventional cycles of chemotherapy or with 3 or 4 cycles of neoadjuvant chemotherapy before CS with HIPEC and 3 postoperative chemotherapy cycles. Hyperthermic intraperitoneal chemotherapy was performed with cisplatin (50 mg/m) for 60 minutes, only in case of complete cytoreduction.
Results:
Nineteen patients were included in the study, and they all underwent neoadjuvant chemotherapy before CS. Sixteen patients underwent complete CS with HIPEC. There was no mortality, and morbidity of CS with HIPEC was acceptable. The HIPEC procedure did not prevent the administration of the standard first-line treatment. In the 16 patients who underwent CS with HIPEC, the outcomes were very good.
Conclusion:
Our study shows an acceptable toxicity of adding HIPEC to the standard first-line treatment in patients with stage III ovarian carcinoma treated with interval CS. Further studies are needed to confirm the role of HIPEC in the treatment of ovarian carcinoma.
