Vineet Talwar
Rajiv Gandhi Cancer Institute and Research Centre, India
Posters & Accepted Abstracts: J Cancer Sci Ther
Background: It has been demonstrated in few trials, that intraperitoneal and intravenous (IP/IV) chemotherapy improves survival in advanced stage ovarian cancer. But it has been associated with high treatment related toxicities leading to very low acceptance of this modality among medical oncologists. So, various modifications in treatment schedules have been tried to reduce toxicities. In this study, we decided to study the response and tolerability of IP paclitaxel on day 8 with IV paclitaxel on day 1 and IV cisplatin day 2 in carcinoma ovary, in view of paucity of data with this modification. Methods: In this prospective observational study, from March 2013 to June 2015, the efficacy and tolerability of adjuvant IP/ IV chemotherapy in optimally cytoreduced stage III epithelial ovarian cancer patients were assessed. Treatment consisted of 135 mg/m2 of IV paclitaxel over a 3-hours period on day 1 followed by AUC 5 carboplatin IV on day 2 and 60 mg/m2 of IP paclitaxel on day 8 every 3 weekly for six cycles. Results: Total 40 patients were enrolled. The median age of patients was 53 yrs (32 yrs�67 yrs). Out of a total of 240 I/P cycles, 211 cycles (88%) were completed. 30 patients (76%) received all the 6 cycles by IP route. 6 out of those 30 patients had one or more adjustment including delay or dose reduction. After median follow up of 18 months, 5 patients (12.5%) had local or systemic recurrence, 2 patients (5%) had progression during treatment. Median progression free survival not reached yet. Catheter block was seen in 5 cases. Two cases had needle displacement and extravasations of drug around the port chamber. 6 patients had grade 3 abdominal pain and cramp. Grade 3/4 Leucopenia was experienced by 20 patients (50%) but Febrile Neutropenia occurred in only 4 (10%) patients. Renal complication present in 2 patients (5%) and transient transfusion reaction developed in 5 patients. Conclusions: In Indian patients, adjuvant chemotherapy with day 8 I/P paclitaxel in optimally cytoreduced epithelial ovarian cancer is associated with survival benefits comparable to western literature and better tolerated with very high treatment completion rate.
Vineet Talwar earned his DM (Medical Oncology) from Adyar Cancer Institute, Chennai. He has more than 40 publications in National and International journals and is member of the European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), Indian Cooperative Oncology Network (ICON), Indian Society of Oncology (ISO). He is a recipient of four orations from the Association Physician of India, Indian Academy of Clinical Medicine. He is also credited as a fellow of International Medical Sciences Academy (IMSA), Indian College of Physicians (FICP) and Fellow of Royal Society of Physicians (FRCP), UK. He is actively involved with the DNB Medical Oncology program which is being conducted at Rajiv Gandhi Cancer Institute and is a thesis guide as well. He actively participates in oncology updates, cancer detection camps, outreach clinics and drug trials (phase I, II, III) at the Institute.
Email: drvineettalwar@yahoo.com
Cancer Science & Therapy received 5282 citations as per Google Scholar report
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