INTRAPERITONEAL CHEMOTHERAPY WITH MITOXANTHRONE IN OVARIAN-CANCER

Aims and background: Ovarian carcinoma remains confined to the periton eal cavity for the greater part of its natural history, so intraperito neal (IF) administration of chemotherapy could result in greater total drug exposure of the tumor and minimize systemic antiblastic drug sid e effects. The aim of this study was to evaluate the therapeutic effic acy and toxic effects of intraperitoneal mitoxanthrone in patients aff ected by ovarian carcinoma with macroscopic absence of disease or mini mal residual disease. Methods: Ten patients were enrolled (stage II an d III) who had been previously treated with neoadjuvant systemic chemo therapy (CDDP or CBDCA + CTX) and radical surgery resulting in macrosc opic absence of disease or minimal residual disease (<1 cm), Mitoxanth rone (25 mg/m(2)) was instilled in 2 liters of normal saline every fou r weeks for 2-4 cycles, Results: A total of 26 courses was administere d; two patients discontinued IP therapy, one for chemoperitonitis and another for bowel perforation requiring catheter removal. Of the 10 pa tients receiving IP chemotherapy, 7 are alive at 5 years from radical surgery, and 3 had relapses at 13, 14 and 57 months, respectively, fro m radical surgery. Conclusions: Intraperitoneal mitoxanthrone appears to be an effective second-line therapy in ovarian cancer; it is well t olerated as far as toxic effects are concerned, allowing cost reductio n and improved patient compliance. For those cases requiring a limited number of peritoneal accesses traditional percutaneous systems have a more favorable cost/benefit ratio.