Further Evidence that Intraperitoneal Chemotherapy Improves Survival in Stage III Ovarian Cancer
According to an article recently published in the journal Cancer, initial treatment including intraperitoneal chemotherapy improves survival in patients with Stage III ovarian cancer.
Approximately 25,000 new cases of ovarian cancer are diagnosed in the U.S. each year. Patients with Stage III ovarian cancer have cancer that has spread from the ovaries and are considered to have advanced disease. Standard treatment for advanced ovarian cancer involves the surgical removal of as much cancer as possible (in patients who are eligible for surgery) as well as chemotherapy and/or radiation therapy.
Intraperitoneal chemotherapy involves the administration of a chemotherapy drug directly into the abdominal cavity. Because ovarian cancer commonly spreads within the peritoneal cavity, researchers have speculated that more direct administration of chemotherapy to the sites of cancer may provide benefit over intravenous (administration into the vein) treatment only.
Last year an important clinical trial published in the New England Journal of Medicine (see “Related News”) demonstrated an improvement in survival with the use of intraperitoneal chemotherapy in patients with Stage III ovarian cancer. Researchers continue to evaluate the effects of intraperitoneal chemotherapy in this patient population.
Researchers affiliated with the Cancer Care Ontario Program for Evidence-Based Care’s Gynecology Cancer Disease Site Group have recently performed a literature review regarding the use of intraperitoneal chemotherapy in the treatment of Stage III ovarian cancer. The researchers reviewed the results of seven clinical trials involving patients with Stage III ovarian cancer who were optimally debulked (surgery that removes all cancer greater than 1 cm) and treated with either intraperitoneal chemotherapy plus intravenous chemotherapy or intravenous chemotherapy only as initial therapy for their disease.
- Overall, patients treated with intraperitoneal chemotherapy had improved survival compared to those treated with intravenous chemotherapy only.
- The largest three clinical trials evaluated demonstrated an improvement in survival of eight months, 11 months, and 16 months for patients treated with intraperitoneal chemotherapy over those treated with intravenous chemotherapy only.
- There were more treatment-related complications among patients treated with intraperitoneal chemotherapy than among those treated with intravenous chemotherapy.
The researchers concluded that this review provides further evidence that intraperitoneal chemotherapy improves survival among patients with optimally debulked Stage III ovarian cancer. The authors added that appropriate clinical facilities are needed to provide optimal treatment for patients with this disease.
Patients diagnosed with Stage III ovarian cancer who are optimally debulked may wish to speak with their physician regarding their individual risks and benefits of treatment with intraperitoneal chemotherapy.
Reference: Elit L, Oliver TK, Covens A, et al. Intraperitoneal chemotherapy in the first-line treatment of women with Stage III epithelial ovarian cancer: a systematic review with meta-analysis. Cancer.2007;109:692-702.