CHEMOTHERAPY AND TOTAL PARENTERAL-NUTRITION FOR ADVANCED OVARIAN-CANCER WITH BOWEL OBSTRUCTION

We retrospectively reviewed the medical records of 21 patients with ad vanced epithelial ovarian carcinoma treated with intravenous chemother apy in an attempt to restore intestinal function following small-bowel obstruction. All patients had a drainage gastrostomy tube placed for palliation of vomiting, and 11 patients received concomitant total par enteral nutrition (TPN). Eight (38%) patients were treated with single -agent paclitaxel, 7 (33%) received platinum-based regimens, and 6 (29 %) received other second-line chemotherapy. The median survival for al l patients post-gastrostomy tube placement was 84 days. The median sur vival for patients with recurrent ovarian cancer who received salvage chemotherapy and TPN was 89 days, longer than for patients who receive d salvage chemotherapy alone (71 days) (P = 0.031). Two of three patie nts with newly diagnosed ovarian cancer and concomitant bowel obstruct ion had sufficient temporary response from chemotherapy with resolutio n of obstruction and removal of the gastrostomy tube. Chemotherapy was ineffective in restoring bowel function in heavily pretreated patient s with recurrent disease. (C) 1997 Academic Press.