Intensive Intraperitoneal Therapy in Advanced Ovarian Cancer

Prior treatment

• Patient who has already been treated with chemo-hyperthermia for ovarian cancer,

Other illness

• General contraindication to the realization of a tumor reduction surgery or HIPEC (contraindication or history allergic reaction to any treatments components),
• Serious life-threatening co-existing condition at stake,
• History of cancer, except basal cell carcinoma of the skin or carcinoma in situ of cervix having recurred within five years prior to entry into this trial,
• Any severe untreated infectious disease,

Lab values

• Renal impairment (clearance \<70 ml / min) according to the MDRD method,
• Hepatic insufficiency (bilirubin \> 1.5 x normal, ASAT \& ALAT \> 3 x upper limit of normal),

Other

• Performance Index (WHO) ≥ 2,
• Stage IV B or IV A with significant pleural effusion (measured on a thoracic CT scanner, the largest thickness of which is more than 3 cm),
• Cardio-respiratory pathology indicating hyper hydration, to be implemented for HIPEC,
• Peripheral sensory neuropathy ≥ grade 2 at the inclusion time,
• Patients whose regular follow-up is a priori impossible for psychological, family, social or geographical reasons,
• Pregnant and / or nursing women,
• Subjects under tutelage, curatorship or safeguard of justice.

• Patients aged 18 to 75 years,
• Patients with high-grade serous (high grade according to MD Anderson, grade II and III according to Silverman) ovarian or tubal or primitive peritoneal histologically proven cancer,
• Initial laparoscopy confirming the histological type, evaluating the extent of the disease by PCI score and confirming the initial non-resectability,
• Stage III B-C (FIGO 2014) or stage IVA with minimal or moderate pleural effusion (measured on a thoracic CT scanner, the largest thickness of which is less than 3 cm),
• Complete interval cytoreduction surgery,
• Indication of 3 to 4 cures of neoadjuvant chemotherapy based on the Carboplatin-Paclitaxel (carbo-taxol) combination,
• The delay between the last course of NAT and the surgery must be between 4 and 8 weeks,
• Hematologic function, hemoglobin ≥ 10 g / dl; PNN ≥ 1 x 109 / L, platelets ≥ 100 x 109 / L,
• Total bilirubin ≤ 1.5 LSN, ALT or AST ≤ 3 ULN,
• Absence of renal insufficiency (creatinine clearance ≤ 70 ml / min) according to the MDRD method,
• Informed consent signed before any specific procedure under consideration,
• Patients affiliated to the French social security scheme or equivalent.