Intraperitoneal chemotherapy for ovarian cancer, stage II
Posted Aug 21 2009 12:22pm
Intravenous, or IV administration, of chemotherapy drugs is done by inserting a needle into a vein in the body, usually in the arm. Intraperitoneal or IP administration of chemotherapy, usually is done through a surgically implanted catheter, which is a hollow, flexible tube that allows passage of fluids into the abdomen of a woman with ovarian cancer. The Gynecologic Oncology Group (GOG) undertook GOG-172 to see whether the improvement in survival noted with IP treatment in other studies was still seen when paclitaxel was given with a platinum drug. GOG conducted a randomized phase III trial to compare a standard regimen of intravenous paclitaxel and cisplatin to an intensive regimen of intravenous paclitaxel and sequential intraperitoneal cisplatin and paclitaxel in previously untreated stage III ovarian cancer. Patients who received part of their chemotherapy via an IP route had a median survival time of 16 months longer than women who received only IV chemotherapy. The 205 women treated via the IP route fared better, even though most of them received fewer than the planned treatments. There were no significant quality-of-life differences between the arms one year after treatment. Compared with standard intravenous paclitaxel plus cisplatin, an intensive regimen of intravenous paclitaxel plus sequential intraperitoneal cisplatin and paclitaxel significantly improved progression-free and overall survival in patients with optimally debulked stage III ovarian cancer. This patient had stage IIC but some guidelines include stage II as well.
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Elit L, Oliver T, Covens A, Kwon J, Fung-Kee-Fung M, Hirte H, Oza A, Gynecology Cancer Disease Site Group. The role of intraperitoneal chemotherapy in the first-line treatment of women with stage III epithelial ovarian cancer: a clinical practice guideline. Toronto (ON): Cancer Care Ontario (CCO); 2006 Aug 3. 23 p. (Evidence-based series; no. 4-21). [26 references]