The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer , neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality .
PURPOSE To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer .
Intraperitoneal cisplatin plus intravenous cyclophosphamide versus intravenous cisplatin plus intravenous cyclophosphamide for stage III ovarian cancer.
BACKGROUND Intravenous platinum-based chemotherapy is the st and ard primary therapy for advanced ovarian cancer . We conducted a phase 3 trial to compare the effects of intraperitoneal and intravenous cisplatin on the survival of women with previously untreated , stage III , epithelial ovarian cancer . METHODS The patients underwent an initial exploratory laparotomy and resection of all tumor masses larger than 2 cm . Within four weeks after surgery , six courses of intravenous cyclophosphamide ( 600 mg per square meter of body-surface area per course ) plus either intraperitoneal cisplatin ( 100 mg per square meter ) or intravenous cisplatin ( 100 mg per square meter ) were administered at three-week intervals . RESULTS Of 654 r and omized patients , 546 were eligible for the study . The estimated median survival was significantly longer in the group receiving intraperitoneal cisplatin ( 49 months ; 95 percent confidence interval , 42 to 56 ) than in the group receiving intravenous cisplatin ( 41 months ; 95 percent confidence interval , 34 to 47 ) . The risk of death was lower in the intraperitoneal group than in the intravenous group ( hazard ratio , 0.76 ; 95 percent confidence interval , 0.61 to 0.96 ; P = 0.02 ) . Moderate-to-severe tinnitus , clinical hearing loss , and neuromuscular toxic effects were significantly more frequent in the intravenous group . CONCLUSIONS As compared with intravenous cisplatin , intraperitoneal cisplatin significantly improves survival and has significantly fewer toxic effects in patients with stage III ovarian cancer and residual tumor masses of 2 cm or less
The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer , neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality .
PURPOSE To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer .