Intraperitoneal Chemotherapy for Ovarian Cancer
Cytoreductive surgery followed by chemotherapy with a platinum and taxane combination constitutes the accepted standard treatment for patients with advanced epithelial ovarian cancer. Intravenous (IV) carboplatin and a 3-h infusion of paclitaxel were considered to be the preferable regimen at a recent international consensus conference. This was due to issues related to ease of administration, toxicity, and quality of life, with no evidence of inferiority to other regimens (1). Despite this, the long-term outlook for patients with advanced ovarian cancer remains poor, although patients with optimally debulked stage III disease have median survivals approaching 5 years. It is in this group of patients (generally with less than 2 cm residual nodules) that the intraperitoneal (IP) administration of chemotherapy has been studied for over 20 years. Since ovarian cancer remains clinically in the peritoneal cavity for much of its natural history, this approach seemed rational. Despite encouraging early results, the IP approach has not been incorporated into the mainstream management of advanced ovarian cancer.
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