[Intraperitoneal chemotherapy of CDDP and etoposide in patients with advanced ovarian cancer]

Intraperitoneal disseminated ovarian cancer has a poor prognosis and its treatment is difficult. Recently, we undertook intraperitoneal chemotherapy (IP) of CDDP (Pt) and etoposide (Et) using an implantable reservoir. The subjects were 14 patients with advanced ovarian cancer. One hundred mg of Pt and 200 mg of Et were administered intraperitoneally through the reservoir, and the therapeutic results were evaluated. In 6 patients, levels of total platinum (t-Pt), free platinum (f-Pt) and Et were determined in the blood and intraperitoneal fluid by flameless atomic absorption spectrophotometry. 1. The 14 patients received 82 courses of IP. In 10 cases of IIIrd stage, no recurrence was detected in 5 radical operable cases, and 4 of 5 inoperable cases were able to undergo radical operation after IP. One case was inoperable even after IP. Recurrences were detected in 2 of 4 cases which subsequently became operable. In a case of IVth stage, remission was achieved, but the tumor markers began rising again 18 months after operation. No further recurrence was detected in a treated recurrence case. In 2 cases of metastatic cancer, recurrences were detected 3 and 7 months after operation, respectively. As a side effect, the incidence of gastrointestinal toxicities, anemia, leukocytopenia and alopecia was high, but the grade was almost 1 or 2. Intraperitoneal mean maximum concentrations were t-Pt: 21.98 +/- 5.78; f-Pt: 17.72 +/- 4.97; Et: 62.98 +/- 23.94 micrograms/ml. Blood mean maximum concentrations were t-Pt: 2.84 +/- 0.41; f-Pt: 0.84 +/- 0.22; Et: 11.38 +/- 2.12 micrograms/ml. Mean AUC of the blood were t-Pt: 57.76 +/- 6.62; f-Pt: 2.96 +/- 0.47; Et: 108.76 +/- 18.94 micrograms.h/ml. 2. IP is considered to be effective for advanced ovarian cancer not only as a local therapy but as a general therapy, and is feasible as maintenance therapy with the implantable reservoir and tolerable side effects.