Combination intraperitoneal chemotherapy with cisplatin, cytarabine, and doxorubicin for refractory ovarian carcinoma and other malignancies principally confined to the peritoneal cavity.

Abstract

Thirty-one patients with refractory ovarian cancer and other malignancies principally confined to the abdominal cavity were treated with an i.p. combination-chemotherapy regiment consisting of cisplatin (100-200 mg/m2), cytosine arabinoside (10-4-10-3 mol/l) and doxorubicin (2-18 .mu.mol/l). Sodium thiosulfate was simultaneously administered i.v. to prevent cisplatin-induced nephrotoxicity. Eight of 26 evaluable patients demonstrated clinical response including 7 of 17 (41%) with ovarian cancer refractory to frontline chemotherapy. Systemic toxicity was mild except for nausea and vomiting. Abdominal pain secondary to doxorubicin was the major complication of therapy. Combination i.p. therapy with cisplatin, cytosine arabinoside and doxorubicin can apparently be safely administered with objective tumor responses observed in patients with ovarian cancer heavily pretreated and in individuals with other malignancies involving the peritoneal cavity. Doxorubicin-induced local pain limits the ability to administer multiple courses of this treatment regimen.