The efficacy of combination chemotherapy including intraperitoneal cisplatinum and mitoxantrone with intravenous ifosfamide in patients with FIGO stage IC ovarian carcinoma

Objective: Patients With stage I ovarian cancer show a high incidence of re current disease ranging from 30% to 50% which may be associated with ii sho rtened survival. Therefore. a subset of early-stage patients with poor prog nostic factors who are most likely to present with recurrent disease in the next few years may benefit from adjuvant treatment. Patients and method. In this pilot study, we evaluated the efficacy of comb ination chemotherapy including intraperitoneal mitoxantrone: (12 mg/m(2)) a nd cisplatinum (75 mg/m(2)) on day 1. in addition to intravenous ifosfamide (4000 mg/m(2)) given on day 15 with mesna protection. Thirteen patients wi th a median age of 44 years were included in the study. Results: Following a median of 5 cycles of chemotherapy. 12 patients had a complete response (92.3%), while one patient had progressive disease. At th e latest follow-up, ten patients were alive with no evidence of disease, tw o patients had died and one patient was lost to follow-up. Overall and prog ression-free survival rates at eight years were 82.5 +/- 11.3% and 83.9 +/- 10.5%. respectively. Excluding grade 3 and 4 abdominal pain in three (23.1 %) patients, there were no serious complications associated with this combi nation. Dose delay not longer than one week was observed in 3 cycles (5.6%) . Port-related complications observed in three patients were colonic perfor ation, hematoma and leakage. Conclusion: This combination has moderate efficacy and tolerable toxicity. However, further studies are required to make definite conclusions regardin g the efficacy of this combination in the adjuvant setting in patients with high-risk early stage ovarian carcinoma.