UTERINE PAPILLARY SEROUS CARCINOMA TREATED WITH INTRAPERITONEAL CISPLATIN AND INTRAVENOUS DOXORUBICIN AND CYCLOPHOSPHAMIDE

This study was designed to evaluate the efficacy of intraperitoneal ci splatin and intravenous doxorubicin and cyclophosphamide in patients w ith uterine papillary serous carcinoma. Sixteen patients with uterine papillary serous carcinoma underwent complete surgical staging and pla cement of an intraperitoneal port. Postoperatively, they received cisp latin (100 mg/m(2)) given intraperitoneally and doxorubicin (50 mg/m(2 )) intravenously and cyclophosphamide (600 mg/m(2)) intravenously ever y 4 weeks for 6 cycles. The intraperitoneal ports did not function in 3 patients immediately following surgery. The remaining 13 patients co nstitute the study group. The patients ranged in age from 37 to 77 yea rs. There were 1 patient with Stage IA, 3 with Stage IB, 2 with Stage IIB, 2 with Stage IIIA, 2 with Stage IIIC, 1 with Stage IVA, and 2 wit h Stage IVB. At the end of surgery no gross residual disease remained except for 1 patient who had less than l-cm nodules in the peritoneal cavity. Eleven of the patients underwent 6 cycles of chemotherapy, 1 p atient underwent 3 cycles, and 1 patient underwent 1 cycle. A total of 71 cycles of chemotherapy were given. All patients developed alopecia . Two patients developed neutropenic fever; one was treated with antib iotics, the other patient died from urosepsis. One patient had a >15% decrease in left ventricular ejection fraction which led to a dose red uction of doxorubicin. One patient had a urinary tract infection and o ne patient developed a port infection which necessitated its removal. Seven patients have died, 1 is alive with disease, and 5 patients are alive with no evidence of disease. Five of the 7 patients with extraut erine disease have died of disease. One is alive with disease and the other is free of disease. The median survival of these patients was 34 months with an overall 3 years survival of only 24.1%. Although the p rotocol was reasonably well tolerated, the overall survival did not di ffer from that of a similar group of patients treated at our instituti on with intravenous chemotherapy. There was a high incidence of dysfun ction of the intraperitoneal ports (25%). This approach with intraperi toneal cisplatin presents no therapeutic advantage for these patients. (C) 1996 Academic Press, Inc.