TREATMENT OF PRIMARY FALLOPIAN-TUBE CARCINOMA WITH CISPLATIN-CONTAINING CHEMOTHERAPY

Because of the rarity of the primary fallopian tube carcinoma, optimal primary therapy is still not well defined, and there is little inform ation available regarding the efficacy of combination chemotherapy in advanced disease. The experience obtained by treating 14 patients with fallopian tube carcinoma-most of them with advanced disease-using a c ombination of cisplatin, adriamycin, and cyclophosphamide (CAP) (10 pa tients) or carboplatin plus cyclophosphamide (4 patients) is reported. One patient had Stage Ic disease, 2 had Stage II, 9 had Stage III, an d 2 had Stage IV. Eleven patients had clinically measurable disease (> 2 cm) at the start of chemotherapy. Eight of these patients had a comp lete clinical response (CR), 2 had partial response (PR), and 1 had pr ogressive disease (PD). Of the 8 CR patients, 5 underwent second-look operation (SLO). Pathological complete response (pCR) confirmed in 4 o ut of 5 patients at SLO. The 3 patients without measurable disease (<2 cm) after primary surgery had an indeterminate response to chemothera py. Two of them (Stages Ic and II, respectively) had a negative SLO, w hile the third patient with Stage IV disease, who refused the SLO, rem ains disease-free 41 + months. This high response rate shows that this carcinoma is very responsive to cisplatin-or cisplatin analogue-conta ining regimens. One pCR and two clinical CR patients relapsed after 20 , 14, and 16 months, respectively, from the completion of chemotherapy and died despite the second-line treatment. The toxicity of the regim ens was moderate. The median survival was 40 months, and the actuarial 5-year survival rate was 48%. Carcinoma of the fallopian tube appears to respond favorably to cisplatin- or carboplatin-containing chemothe rapy.