Intraperitoneal chemotherapy in ovarian cancer: a review of tolerance and efficacy

نویسندگان

  • Daniel L Chan
  • David L Morris
  • Archana Rao
  • Terence C Chua
چکیده

PURPOSE TO REVIEW THE TWO MAIN APPROACHES OF INTRAPERITONEAL (IP) CHEMOTHERAPY DELIVERY IN OVARIAN CANCER: postoperative adjuvant IP chemotherapy after cytoreductive surgery (CRS) and intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS A literature search was conducted to identify studies that employed postoperative adjuvant IP chemotherapy after CRS or combined CRS and intraoperative HIPEC in patients with ovarian cancer. Data of interest included chemotherapy protocol, morbidity and mortality, and survival data. RESULTS Three large randomized controlled trials comprising 707 patients with advanced ovarian cancer who received postoperative adjuvant IP chemotherapy were reviewed. Morbidity rate ranged from 56% to 94% in IP chemotherapy, and mortality rate ranged from 1% to 2%. Median disease-free survival ranged from 24 to 28 months, and overall survival ranged from 49 to 66 months. Planned chemotherapy completion rates ranged from 42% to 71%. Twenty-four nonrandomized studies that reported HIPEC comprised 1167 patients with both advanced and recurrent ovarian cancer. In patients with advanced ovarian cancer, mortality ranged from 0% to 5%, minor morbidity ranged from 16% to 90%, and major morbidity ranged from 0% to 40%. Median disease-free survival ranged from 13 to 56 months, and overall survival ranged from 14 to 64 months. Survival at 5 years ranged from 35% to 70%. In patients with recurrent ovarian cancer, the mortality rate ranged from 0% to 10%, minor morbidity ranged from 7% to 90%, and major morbidity ranged from 0% to 49%. Median disease-free survival ranged from 13 to 24 months and overall survival from 23 to 49 months. Survival at 5 years ranged from 12% to 54%. CONCLUSION There is level-one evidence suggesting the benefit of postoperative adjuvant intraperitoneal chemotherapy for patients with advanced ovarian cancer after cytoreductive surgery, albeit catheter-related complications resulted after treatment discontinuation. Studies report the use of HIPEC predominantly in the setting of recurrent disease and have demonstrated encouraging results, which merits further investigation in future clinical trials.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

CONSOLIDATION TREATMENT WITH INTRAPERITONEAL CISPLATIN IN EPITHELIAL OVARIAN CANCER FOLLOWING NEGATIVE SURGICAL ASSESSMENT

Objective: The goal of this study is to evaluate the efficacy of intraperitoneal (JP) cisplatin as consolidation treatment, in epithelial ovarian cancer patients with pathologically negative surgical reassessment, following first-line platinum-based chemotherapy. Methods: This study included 22 patients with FIGO stage (IIc- IV) epithelial ovarian cancer (EOC) which had no evidence of disea...

متن کامل

Intraperitoneal Therapy of Ovarian Cancer.

PURPOSE: This is a review of the rationale for the intraperitoneal administration of antineoplastic agents in the management of ovarian cancer. PATIENTS AND METHODS: Patients have been treated in a number of clinical trials to define the toxicity profile and efficacy of intraperitoneal therapy in this clinical setting. RESULTS: Phase I-II trials have confirmed that a number of cytotoxic and bio...

متن کامل

Fallopian Tube Carcinoma: A Case Report and Review of Litrature

Primary fallopian tube carcinoma is a rare tumor that histologically and clinically resembles epithelial ovarian cancer. Here we introduce a case of tubal carcinoma in a postmenopausal woman. The diagnosis of primary fallopian tube carcinoma is rarely considered preoperatively and is usually first appreciated by the pathologist. Because of low frequency of tubal carcinoma, there are few systemi...

متن کامل

Pnm-5: Anti-Mullerian Hormone in The Assessment and follow up of Cancer in Young Females

Background The impact of cancer therapy on the reproductive potential of patients is increasingly recognized because survival rates of patients have clearly improved in recent years. The study stressed the use of AMH may allow better prediction of chemotherapy-related risk to further fertility. MaterialsAndMethods A narrative review was performed within articles published at PubMed, Elsevier, S...

متن کامل

Chemotherapy-induced Ovarian Failure And The Related Indices In Breast Cancer Patients

Background and Objective: It is well known that menstrual period and ovarian function are affected by chemotherapy. Although breast cancer is the most common cause of chemotherapy in women and ovarian hormones have very important direct and indirect effects on overall survival, disease-free survival, and...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 4  شماره 

صفحات  -

تاریخ انتشار 2012