Serum, fat and pelvic tissue levels of piperacillin or mezlocillin (patients randomly selected to receive one of both) were measured during surgery of 48 patients (mean age 55 years) with gynecologic cancer and related to the minimal inhibitory concentrations (MIC). Only during the first 3 hours the fat and pelvic tissue levels of these antibiotics were above the MIC levels (3 to 5 mg/l), while the serum reached marginal levels after 4 to 5 hours. Excessive blood loss (more than 1.500 ml) decreases the serum and fat levels; however, during the first 3 hours not below the MIC values. Single-dose prophylaxis with both antibiotics appeared fully effective in debulking surgery, total abdominal hysterectomy and radical hysterectomy. However, out of a group of 12 patients who underwent radical vulvectomy, 8 patients had postoperative infections.

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PubMedDate not supplied

Treatment of advanced ovarian carcinoma with a combination of hexmethylmelamine, cyclophosphamide, methotrexate, and 5-fluorourcil (hexa-CAF) in patients with and without previous treatment.

Forty patients with stage III or IV epithelial ovarian tumors were treated with a combination of hexamethylmelamine, cyclophosphamide, methotrexate, and 5-fluorouracil. Fourteen of 37 evaluable patients had recieved previous treatment. Three of these 14 previously treated patients responded; no complete remissions were achieved and more severe toxicity was seen compared with the 23 previously untreated patients. In the latter group of patients, seven partial remissions and five complete remissions documented by peritoneoscopy and laparotomy were achieved. It is concluded that the combination of hexamethylmelamine, cyclophosphamide, methotrexate, and 5-fluorouracil is not useful as second-line chemotherapy but can be considered suitable for remission induction in previously untreated patients.

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