CHROMIC PHOSPHATE THERAPY IN CARCINOMA OF THE OVARY

BACKGROUND: Adjuvant therapy with intraperitoneal (TP) chromic phospha te (P-32) instillation in both early and advanced carcinoma of the ova ry requires adequate intra-abdominal distribution for maximum therapeu tic benefit. Abdominal-pelvic computed tomographic (CT) scanning with water-soluble IP contrast to establish the absence of intra-abdominal adhesions prior to P-32 instillation has not been previously reported. STUDY DESIGN: Sixteen patients with carcinoma of the ovary who were o ffered IP P-32 therapy between January 1988 and December 1992 were ret rospectively reviewed. Computed tomographic scans on 13 patients were reevaluated using a modification of Muggia and associates' distributio n scoring system. RESULTS: Of the 16 patients, one had a negative seco nd look operation for stage IIIc carcinoma of the ovary. The remaining 15 with stage I and II disease underwent at least a staging laparotom y, bilateral salpingo-oophorectomy, and omentectomy. The mean time fro m operation to IP P-32 attempt was 28 days with a range of 17 to 90 da ys. Adequate distribution was considered present in two of the three c ases evaluated by technitium scanning and in four of the 13 cases stud ied by CT scanning. On review, 12 of 13 cases studied by CT scans reve aled some areas of IP contrast exclusion and loculation. CONCLUSIONS: We suspect that uneven postoperative IP P-32 distribution is common an d may be missed by two-dimensional imaging techniques such as techniti um scanning or fluoroscopy.