• One-time intra-abdominal administration of radioactive phosphate versus six cycles of intravenous cisplatin +
cyclophosphamide .
• Intra-abdominal carboplatin , cisplatin or etoposide with or without other anticancer drugs.
Stages IIb, IIc, IIIa, IIIb, IIIc, IV
Standard Treatment In women with advanced ovarian carcinoma , standard therapy involves removing as much of the tumor as possible as well as the uterus , both fallopian tubes and ovaries and the omentum. Biopsies from the pelvic and para-aortic nodes are also performed if abnormal.
If there is optimal residual disease after surgery—no tumor implant greater than 1 cm (1/3 in.) in diameter—combination chemotherapy including cisplatin + Taxol (CT) and cisplatin or carboplatin + cyclophosphamide is given for six cycles (one course every three weeks).
Total abdominal and pelvic radiation may be given, but only if the residual disease is less than 0.5 cm (1/4 in.) in diameter. Intra-abdominal radioactive phosphate may be given only if the residual disease is less than 1 mm in diameter.
If there is residual cancer larger than 1 cm (1/3 in.) in diameter or metastases outside the abdominal cavity, intravenous chemotherapy is used exclusively. The commonly used combinations are the same as used for Stage IIa, namely CT, CP, CAP, AP and CHAD.
