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Whole Abdomen Radiation in Conjunction With Intraperitoneal Chemotherapy for the Treatment of Small Volume Recurrent Ovarian Carcinoma Limited to the Peritoneal Cavity: A Phase I Trial

Phase 1
18 Years
Not Enrolling
Recurrent Ovarian Carcinoma

Thank you

Trial Information

Whole Abdomen Radiation in Conjunction With Intraperitoneal Chemotherapy for the Treatment of Small Volume Recurrent Ovarian Carcinoma Limited to the Peritoneal Cavity: A Phase I Trial

DESIGN: This is an open label, single arm, dose finding study.

STUDY PROCEDURES: Patients will receive chemotherapy and radiation for four weeks, and we
will check for any problems from the treatment for 3 months. We would like to collect
information from the patients regular doctor for 1 year after this treatment.

Pre-screening If patients decide to participate in this study the doctor will evaluate if
they have met all the criteria to be eligible. To participate the cancer cannot have spread
outside the abdomen and patients must have had only one type of chemotherapy for their
cancer. If there any of their previous scans or blood tests show that the cancer has spread
outside the abdominal cavity, patients will not be able to participate in this study.
Patients will also not be able to participate in this study if it is determined that their
cancer has come back less than six months after they completed their first treatment of
chemotherapy. If these criteria are met, the standard next step for treatment is to have a
second surgery to remove all or most of the cancer from the abdominal cavity. This will
involve a similar surgery to what patients had when their cancer was first diagnosed. During
this surgery we will place a special catheter or tube within the abdominal cavity so that we
can administer chemotherapy into the abdomen directly and deliver it to the remaining

Screening Procedures:

The following screening tests, exams and procedures will be done:

- Recording of medical history, physical exam (including vital signs, height & weight
assessment, pelvic examination)

- Blood tests (approximately 2-3 teaspoons will be drawn)

- Urine tests

- Quality of life questionnaire

- If patients have a history of hearing loss, they will have a hearing test because
cisplatin can affect hearing.

Chemotherapy and Radiation Treatment:

- Chemotherapy (Cisplatin) will be given to after recovery from surgery. It will be given
once per week at the same time as patients begin receiving the radiation treatment for
the first 4 weeks. The chemotherapy will be given through the catheter (tube) that was
placed under the skin during surgery and will not be visible. Patients will receive
medication prior to the chemotherapy to prevent nausea, vomiting, and possible allergic
reaction. Each infusion of chemotherapy will take approximately 60 minutes. After
patients receive the drug we will ask to change positions to ensure that the drug comes
in contact with all parts of the abdomen.

- Radiation therapy will be administered for four weeks. Radiation treatments will be
given every day (Monday through Friday) for approximately four weeks.

- Weekly blood tests will be taken before patients receive the chemotherapy
(approximately 2-3 teaspoons) to monitor the effects of the drug on the body.

- The study doctor will evaluate patients weekly with a physical exam and review their
blood tests for any side effects they might be having from the chemotherapy or
radiation treatments.

- Complete a quality of life questionnaire each week.

At the end of treatment (beginning of week 5) AND approximately 90 days after the completion
of treatment patients will have a physical exam, blood tests evaluation of the side effects,
and will complete a quality of life questionnaire.

At the end of treatment, patients will likely undergo additional standard chemotherapy
treatment. We would like to collect and review the information about their progress and
care for 12 months.

Inclusion Criteria:

1. Recurrent ovarian cancer or primary peritoneal cancer with disease confined to the
abdomen and pelvis, who have undergone optimal cytoreductive surgery for recurrence

2. Must have received only one prior chemotherapeutic regimen as their prior therapy

3. Eligible patients must have received platinum based intravenous chemotherapy as their
only prior therapy. Previous treatment with maintenance chemotherapy after initial
adjuvant chemotherapy is acceptable, including anti-estrogen therapy and growth
factors. Previous intraperitoneal chemotherapy is not allowed

4. Patients have evidence of recurrent cancer manifested by either a) elevation in serum
CA-125 or a palpable tumor on physical exam and/or b) radiographic evidence of
recurrence. (Note that a tissue biopsy for histologic confirmation of tumor
recurrence prior to cytoreductive surgery is not necessary, however histologic
confirmation of the removed tumor is necessary- see exclusion 5.22)

5. Tumors with serous, mucinous, clear cell, or endometrioid histologic types are

6. Recurrent disease must be confined to the abdominal cavity

7. Recurrence of tumor must be greater than six months from completion of primary
chemotherapy (platinum sensitive ovarian cancer)

8. Patients have undergone a second cytoreductive surgery to remove all gross residual
disease. This cytoreductive surgery must occur within twelve weeks of enrollment

9. Patients have or are planning to have an IP catheter

10. Patients who require rectosigmoid resection with primary anastamosis will be eligible

11. Adequate renal function as defined by serum creatinine less 2.0mg/dL

12. Patients must have appropriate hematologic parameters with total white blood cell
(WBC) counts ≥ 3,000cells/mcl and platelet counts ≥ 100,000/mcl prior to treatment

13. Patients must have the absence of pleural effusions on chest radiographs

14. Patients must sign informed consent approved by the University of Utah and
institutional review board (IRB)

15. ECOG performance status less than or equal to 2

16. Age greater than 18 years old

Exclusion Criteria:

1. Patients previously characterized with stage IV disease or those with stage IIIC who
underwent suboptimal secondary cytoreductive surgery for recurrence will not be
eligible for participation

2. Patients who undergo secondary cytoreductive surgery for recurrence and have no
recurrent disease by histologic documentation will not be eligible

3. Those with preoperative evaluation consistent with stage IV disease (pleural effusion
or liver parenchymal disease)

4. Patients with disease outside the peritoneal cavity including disease in the thorax,
within the parenchyma of the liver, spleen, or retroperitoneal nodal disease will not
be eligible for participation

5. Patients with other invasive malignancies, with the exception of non-melanoma skin
cancer, who had (or have) any evidence of the other cancer present within the last 5
years or whose previous cancer treatment contraindicates this protocol therapy

6. Patients determined to have platinum resistant ovarian or primary peritoneal cancer

7. Those who had suboptimal cytoreductive surgery at the time of first diagnosis. This
includes patients who had a suboptimal cytoreductive surgery followed by
chemotherapy, then a secondary debulking and now have a recurrence

8. Those with > 1cm residual disease after the second cytoreductive surgery

9. Patients that have been treated with previous intraperitoneal chemotherapy

10. Patients that are pregnant or lactating

11. Patients with peripheral neuropathy greater than grade 2 at baseline

Type of Study:


Study Design:

Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Determine the maximum tolerated dose (MTD) of whole abdomen radiation in conjunction with intraperitoneal cisplatin chemotherapy in the treatment of women with small volume (< 1 cm) recurrent ovarian cancer confined to the abdominal peritoneal cavity

Outcome Time Frame:

2 years after study start

Safety Issue:


Principal Investigator

Andrew P. Soisson

Investigator Role:

Principal Investigator

Investigator Affiliation:

Huntsman Cancer Institute


United States: Institutional Review Board

Study ID:




Start Date:

July 2009

Completion Date:

April 2010

Related Keywords:

  • Recurrent Ovarian Carcinoma
  • Recurrent Ovarian Carcinoma
  • Cancer
  • Carcinoma
  • Ovarian Neoplasms
  • Neoplasms, Glandular and Epithelial



Huntsman Cancer InstituteSalt Lake City, Utah  84112