According to an article recently published in the Journal of Clinical Oncology, intraperitoneal chemotherapy tends to have greater side effects during and immediately following treatment than intravenous chemotherapy. However, neurotoxicity (damage to the nervous system) was the only side effect that remained greater for an extended time among patients treated with intraperitoneal chemotherapy.
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 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 be more effective than intravenous (administration into the vein) treatment only. Although intraperitoneal chemotherapy improves outcomes compared with intravenous chemotherapy for patients with Stage III ovarian cancer, associated side effects and impact on quality of life are still being evaluated.
Researchers recently evaluated quality-of-life issues associated with intraperitoneal chemotherapy among patients with Stage III ovarian cancer. This quality-of-life data was recorded in the Gynecologic Oncology Group (GOG 172) clinical trial in which patients were treated with either intraperitoneal or intravenous chemotherapy including the agents Taxol® (paclitaxel) and Platinol® (cisplatin); the two treatment groups were directly compared. In this trial, both progression-free survival and overall survival were significantly improved among patients treated with intraperitoneal chemotherapy.
The current study includes patient-reported quality-of-life assessments for intraperitoneal and intravenous chemotherapy. Assessments were completed at the following intervals: prior to therapy, before the fourth cycle of chemotherapy, three to six months following chemotherapy, and 12 months following chemotherapy.
- Patients treated with intraperitoneal chemotherapy reported worse abdominal pain, health-related quality-of-life disruption, and neurotoxicity during treatment than patients treated with intravenous chemotherapy.
- Twelve months following therapy, only neurotoxicity remained greater for patients treated with intraperitoneal chemotherapy than for those treated with intravenous chemotherapy.
- Quality of life was improved for both groups of patients over time.
The researchers concluded that intraperitoneal chemotherapy is associated with significantly greater side effects during therapy than intravenous chemotherapy. However, it appears that neurotoxicity is the only side effect that remains significantly greater at 12 months following therapy for patients treated with intraperitoneal chemotherapy.
Patients with ovarian cancer may wish to speak with their physician regarding their individual risks and benefits of intraperitoneal chemotherapy.
Reference: Wenzel L, Huang H, Armstrong D, et al. Health-related quality of life during and after intraperitoneal versus intravenous chemotherapy for optimally debulked ovarian cancer: a Gynecologic Oncology Group study. Journal of Clinical Oncology. 2007; 25: 437-443.