Chemotherapy and total parenteral nutrition for advanced ovarian cancer with bowel obstruction.

Overview

We retrospectively reviewed the medical records of 21 patients with advanced epithelial ovarian carcinoma treated with intravenous chemotherapy in an attempt to restore intestinal function following small-bowel obstruction. All patients had a drainage gastrostomy tube placed for palliation of vomiting, and 11 patients received concomitant total parenteral nutrition (TPN). Eight (38%) patients were treated with single-agent paclitaxel, 7 (33%) received platinum-based regimens, and 6 (29%) received other second-line chemotherapy. The median survival for all patients post-gastrostomy tube placement was 84 days. The median survival for patients with recurrent ovarian cancer who received salvage chemotherapy and TPN was 89 days, longer than for patients who received salvage chemotherapy alone (71 days) (P = 0.031). Two of three patients with newly diagnosed ovarian cancer and concomitant bowel obstruction had sufficient temporary response from chemotherapy with resolution of obstruction and removal of the gastrostomy tube. Chemotherapy was ineffective in restoring bowel function in heavily pretreated patients with recurrent disease.