A rationale for neoadjuvant systemic treatment followed by surgical assessment and intraperitoneal chemotherapy in patients presenting with non-surgically resectable ovarian or primary peritoneal cancers.

摘要

PURPOSE: Optimal management of patients with advanced ovarian or primary peritoneal cancers who have received, and achieved an excellent response to, neoadjuvant chemotherapy remains undefined. METHODS: Five patients are briefly presented who were found to have extensive intra-abdominal carcinomatosis from ovarian/peritoneal cancers and were initially treated with a carboplatin/paclitaxel-based neoadjuvant chemotherapy program. Following major objective and subjective responses each patient underwent a surgical re-assessment and subsequently received single-agent intraperitoneal platinum (cisplatin or carboplatin). RESULTS AND CONCLUSION: In the absence of definitive data from randomized phase-3 trials defining optimal management in this setting, a rational argument can be provided supporting the use of this multi-modality management strategy (neoadjuvant chemotherapy followed by surgery and regional chemotherapy) in carefully selected patients presenting with extensive ovarian or primary peritoneal cancers.