TY - JOUR
T1 - Salvage intraperitoneal mitoxantrone therapy of ovarian cancer
T2 - Influence of increasing the volume of treatment
AU - Markman, Maurie
AU - Hakes, Thomas
AU - Reichman, Bonnie
AU - Rubin, Stephen
AU - Curtin, John
AU - Barakat, Richard
AU - Jones, Walter
AU - Lewis, John L.
AU - Almadrones, Lois
AU - Hoskins, William
PY - 1993/1/1
Y1 - 1993/1/1
N2 - Despite the demonstrated activity of intraperitoneal mitoxantrone in patients with small volume-platinum-refractory ovarian cancer, previous reports have revealed that many patients fail to achieve adequate distribution of the cytotoxic drug throughout the peritoneal cavity when delivered in a ‘standard’ 2-liter treatment volume. In an effort to improve the distribution and therapeutic efficacy of intraperitoneal mitoxantrone, 22 patients with platinum-refractory ovarian cancer were treated with the drug at a dose of 10 mg/m2 given in 2 liters of normal saline followed by an additional 1-2 liters every 2 weeks for eight cycles. The surgically defined complete response rate in 17 patients evaluable for response with platinum- refractory ovarian cancer was 24%, with an overall response rate of 29%. Of 18 in which the influence of treatment volume could be examined (4 patients developed catheter failure), 12 (67%) were able to tolerate a 4-liter treatment volume for >80% of courses, with a total of 15 patients (83%) receiving treatment with a minimum of a 3-liter treatment volume. We conclude that it is possible to safely increase the intraperitoneal treatment volume to 3-4 liters in most patients undergoing this therapeutic strategy. While the impact on therapeutic efficacy of expanding the volume employed for cytotoxic drug delivery remains to be defined, in theory this approach may optimize the opportunity for agents achieving high-intraperitoneal concentrations to produce their maximal cytotoxic effect.
AB - Despite the demonstrated activity of intraperitoneal mitoxantrone in patients with small volume-platinum-refractory ovarian cancer, previous reports have revealed that many patients fail to achieve adequate distribution of the cytotoxic drug throughout the peritoneal cavity when delivered in a ‘standard’ 2-liter treatment volume. In an effort to improve the distribution and therapeutic efficacy of intraperitoneal mitoxantrone, 22 patients with platinum-refractory ovarian cancer were treated with the drug at a dose of 10 mg/m2 given in 2 liters of normal saline followed by an additional 1-2 liters every 2 weeks for eight cycles. The surgically defined complete response rate in 17 patients evaluable for response with platinum- refractory ovarian cancer was 24%, with an overall response rate of 29%. Of 18 in which the influence of treatment volume could be examined (4 patients developed catheter failure), 12 (67%) were able to tolerate a 4-liter treatment volume for >80% of courses, with a total of 15 patients (83%) receiving treatment with a minimum of a 3-liter treatment volume. We conclude that it is possible to safely increase the intraperitoneal treatment volume to 3-4 liters in most patients undergoing this therapeutic strategy. While the impact on therapeutic efficacy of expanding the volume employed for cytotoxic drug delivery remains to be defined, in theory this approach may optimize the opportunity for agents achieving high-intraperitoneal concentrations to produce their maximal cytotoxic effect.
KW - Adult
KW - Aged
KW - Female
KW - Humans
KW - Injections, Intraperitoneal
KW - Middle Aged
KW - Mitoxantrone/administration & dosage
KW - Ovarian Neoplasms/drug therapy
KW - Salvage Therapy
UR - http://www.scopus.com/inward/record.url?scp=0027174815&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:A1993LG21300008&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1006/gyno.1993.1105
DO - 10.1006/gyno.1993.1105
M3 - Article
C2 - 8504986
SN - 0090-8258
VL - 49
SP - 185
EP - 189
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 2
ER -