• Intra-abdominal cisplatin or carboplatin or etoposide with or without other anticancer drugs.
• Intra-abdominal radioactive phosphate.
Stage IIa
Standard Treatment The surgical procedure is the same as for Stage Ic, again with biopsy of any suspicious lesions and washings of the abdominal cavity to check for malignant cells .
If all tumor implants are less than 1 cm (1/3 in.) in diameter after surgery, combination chemotherapy including cisplatin or carboplatin + cyclophosphamide is given to the majority of patients for six cycles (one course every three weeks).
Whole-abdomen and pelvic radiation may be given if the residual disease is less than 0.5 cm (1/4 in.) in diameter.
If there is residual cancer greater than 2 cm (3/4 in.) in diameter, intravenous chemotherapy is used exclusively. There are several commonly used combinations—CT (cisplatin + Taxol), CP (cyclophosphamide + cisplatin or cyclophosphamide + carboplatin), CAP (cyclophosphamide + doxorubicin + cisplatin), AP (doxorubicin + cisplatin) and CHAD (cyclophosphamide + hexamethylmelamine + doxorubicin + cisplatin).
