Intraperitoneal mitoxantrone via temporary catheter in patients with ovarian cancer: Toxicity and feasibility evaluation

A total of 44 patients with epithelial ovarian cancer treated with a variety of first-line agents received intraperitoneal (IP) doses of mitoxantrone in 164 courses from September 1986 to December 1989. Patients with refractory or recurrent bulky tumor after first-line therapy received single doses of mitoxantrone 25 mg/m2 every 3 weeks (n=14) or doses of 15 mg/m2 weekly (n=6). The remaining 24 patients had minimal or absent residual tumors after first-line therapy and were administered combination therapy with IP mitoxantrone, cisplatin, and alpha2(b) interferon. A temporary intravenous teflon 18-gauge catheter was used to instill a large volume (2000 mL) of drug in order to ensure uniform wide distribution. No serious complications of catheter insertion were observed. The major side effect associated with therapy was abdominal pain in 32 of 44 patients for a total of 104 courses, of which patients who received mitoxantrone alone accounted for 44 courses. There were no reports of severe abdominal pain in patients who received the drug weekly. In patients treated with mitoxantrone alone, ≥ Grade 3 myelosuppression occurred in 2 of 20 patients, compared with 9 of 24 who received the drug in combination with the other agents. Overall, 11 favorable responses, including 4 complete tumor regressions and 3 no changes were reported in the group treated with mitoxantrone alone for a median duration of 7 months (range 2-21 months). Of the 20 evaluable patients with minimal disease, 11 achieved complete disease response; 8 are still alive and free of disease after a median follow-up of 16 months. We concluded that IP mitoxantrone via a temporary catheter is an effective, safe, and feasible treatment in ovarian cancer.