Intraperitoneal Paclitaxel as Consolidation Treatment in Ovarian Cancer Patients: A Case Control Study

Abstract

Objective: It was the aim of this study to assess the role, feasibility and safety of consolidation intraperitoneal (IP) paclitaxel in patients affected by advanced ovarian cancer. Methods: Patients affected by advanced ovarian cancer with complete pathological response after standard treatment were enrolled in this study. The consolidation chemotherapy schedule consisted of 12–16 cycles of IP paclitaxel, 60 mg/mq weekly (group A). Chemotherapy was delivered with a direct puncture under ultrasonographic guidance at each cycle. Survival data of this group of patients were compared with those from a control group with analogous characteristics submitted to observation only (group B). Results: Seventy patients were included in the study, 28 in group A and 42 in group B. Treatment-related toxicity was mild. In 3/28 patients (11%), technical difficulties in accessing the peritoneum were observed. Median time to recurrence was 25 months (range 4–64) in group A and 17.5 months (range 2–60) in group B. Estimated 3-year disease-free survival was 56and 33% (p < 0.05) in group A and B, respectively; no significant difference in 3-year overall survival was observed (87 vs. 83%; p value not significant). Conclusion: Weekly IP consolidation chemotherapy with paclitaxel 60 mg/mq is well tolerated and, in this experience, a prolongation of progression-free survival was observed.

Paclitaxel and Its Evolving Role in the Management of Ovarian Cancer

“…The median time to recurrence was 25 months but overall survival did not differ significantly when compared with control group submitted to observation only. Treatment-related toxicity was mild and technical difficulties were observed in 11% of patients [ 142 ].…”

Intraperitoneal Chemotherapy by Ultrasound-Guided Direct Puncture in Recurrent Ovarian Cancer: Feasibility, Compliance, and Complications

“…1Y3 Furthermore, in consolidation therapy, the results of nonrandomized trials showed a longer progression-free survival than controls. 4,5 For these reasons, IP chemotherapy has been considered a promising strategy.…”

“…11 To reduce the high catheter complication rate, previous studies reported successful IP access via direct injection using a peripheral venous catheter as a possible way to administer IP therapy. 5,6,12 In light of these promising results, since 2008, we conducted a prospective pilot study to investigate the feasibility, complication rate, and compliance of the administration of IP chemotherapy by direct puncture under ultrasonographic guidance in more than 400 procedures, performed on consecutive patients with recurrent ovarian cancer (ROC).…”