Intraperitoneal chemotherapy for the initial management of primary epithelial ovarian cancer

Abstract

Background-Ovarian cancer tends to be chemosensitive and confine itself to the surface of the peritoneal cavity for much of its natural history. These features have made it an obvious target for intraperitoneal (IP) chemotherapy. Chemotherapy for ovarian cancer is usually given as an intravenous (IV) infusion repeatedly over five to eight cycles. Intraperitoneal chemotherapy is given by infusion of the chemotherapeutic agent directly into the peritoneal cavity. There are biological reasons why this might increase the anticancer effect and reduce some systemic adverse effects in comparison to IV therapy. Objectives-To determine if adding a component of the chemotherapy regime into the peritoneal cavity affects overall survival, progression-free survival, quality of life (QOL) and toxicity in the primary treatment of epithelial ovarian cancer.

Comparative Study of Grade 3/4 Toxicity Associated With Intraperitoneal Chemotherapy Administered After Primary Versus Interval Surgical Debulking in Ovarian Cancer

“…10 Despite this proven advantage, the adoption of IP chemotherapy has been slow in North American oncologic centers. A recent survey of the members of the Society of Gynecologic Oncologist and the American Society of Clinical Oncology reported that the top reasons given by those not using IP chemotherapy were concerns regarding excessive toxicity (63%) and not having the facilities to administer an IP infusion (16%).…”

Hyperthermic intraperitoneal chemotherapy with and without cytoreductive surgery for epithelial ovarian cancer

“…[18] GOG-172 was the third of three, large randomized studies [18,28,48] reporting a benefit for intraperitoneal chemotherapy. A Cochrane Systematic Review of all randomized trials of intraperitoneal chemotherapy in ovarian cancer involving 1819 patients also revealed an overall benefit of intraperitoneal chemotherapy [49].…”

Intraperitoneal chemotherapy in the management of patients with advanced epithelial ovarian cancer: a critical review of the literature

“…The Cochrane meta-analysis of these eight randomized trials enrolling 1819 patients showed that women who received an IP component of chemotherapy experienced a better progression-free survival (HR: 0.79, 95% CI: 0.69-0.90) and a better overall survival (HR: 0.79, 95% CI: 0.70-0.90) (73) . There was greater serious toxicity as gastrointestinal effects, pain, and fever but less ototoxicity with the IP treatment.…”