INTERPERITONEAL THERAPY WITH CISPLATIN/CARBOPLATIN AND FUDR IN OVARIAN CANCER

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Standard treatment of stage-III and -IV ovarian cancer has been surgical resection followed by intravenous paclitaxel and a platinum compound, which stops progression in 80% and results in negative findings in 20% of patients at -second-look+ surgery. When residual disease is detected, therapy is less clear. In pilot studies, intraperitoneal (IP) floxuridine (FUdR) and cisplatin showed encouraging results. Subjects to be entered will be those who have completed stage-I chemotherapy for ovarian cancer but at -second-look+ surgery have > 1 cm peritoneal disease. IP catheters will be placed. FUdR (3g) will be given IP for 3 days, and cisplatin (60 mg/m2) will be given IP on the third day. (When applicable, carboplatin [500 ml] may follow immediately after FUdR.) This treatment cycle will be repeated every 3 weeks. Total duration of treatment will consist of 6 consecutive cycles as long as there is no progression or intolerable toxicity. Subjects will be assessed with a CT scan of the abdomen with IP contrast 6 weeks and one year after therapy or whenever recurrence is suspected. This protocol has been extended to patients with Gi malignancies which have peritoneal spread.