Weekly Administration of Paclitaxel and Carboplatin in the Treatment of Advanced Ovarian or Peritoneal Cancers With Poor Performance Status

Introduction: We aim to assess the efficacy and safety of weekly paclitaxel and carboplatin administration as first-line chemotherapy for patients with poor performance status (PS) with advanced ovarian or peritoneal cancer. Patients and Methods: We retrospectively reviewed patients with poor PS (PS 3 or 4) with advanced ovarian or peritoneal cancer who were treated with weekly paclitaxel (80 mg/m2) plus carboplatin (area under the curve of 2) therapy at the National Cancer Center Hospital, Tokyo, between 2001 and 2008. Results: Of 159 patients with newly diagnosed advanced ovarian or peritoneal cancer, the number of patients with poor PS was 14 (8.8%). The major reason for poor PS was a large amount of peritoneal and/or pleural effusion (9 patients), bowel obstruction (4 patients), and bone metastasis (1 patient). Four patients underwent laparotomy, but all of them were suboptimally debulked tumors, including exploratory laparotomy in 2 patients. Ten patients were considered to be unresectable with poor general condition. Fourteen patients were treated with weekly paclitaxel and carboplatin. Response was observed in 5 patients. Four patients died within 30 days from last chemotherapy with toxicities, and 3 of them had severe bowel obstruction. The median overall survival time was 57 days (range, 14-1711 days), with 43% (n = 6) of the patients surviving over 3 months. Conclusion: Chemotherapy for patients with poor PS with advanced ovarian or peritoneal cancer resulted in poor prognosis because of disease progression and severe toxicities, especially in cases with small bowel obstruction; however, some patients with response might have survival benefit.