Intraperitoneal chemotherapy for advanced stage ovarian cancer?


Petignat P, du Bois A, Bruchim I, Fink D, Provencher DM.
Should intraperitoneal chemotherapy be considered as standard
first-line treatment in advanced stage ovarian cancer?
Crit Rev Oncol Hematol. 2007 May;62(2):137-147. Epub 2006 Dec 26.
PMID: 17188887 [PubMed - as supplied by publisher]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=17188887&dopt=Abstract>

Gynecologic Oncology Service, Centre Hospitalier de
l'Universite de Montreal (CHUM)-Hopital Notre-Dame, Montreal,
Quebec, Canada; Gynecologic Oncology and Senology Unit,
Geneva University Hospitals, Geneva, Switzerland.

Current standard therapy for patients with advanced stage
epithelial ovarian cancer is cytoreductive surgery followed
by combination chemotherapy with paclitaxel and carboplatin.
Intraperitoneal (IP) chemotherapy has demonstrated improved
outcome compared to standard intravenous treatment in three
large randomized phase III trials and confirmed by Cochrane
meta-analysis. Although compelling evidence suggests that IP
therapy provides survival benefit in a selected group of
ovarian cancer patients, it remains unclear which group of
patients will really benefit from IP therapy, which is the
optimal drug, dose and combination, and what is the real
benefit of IP treatment alone. Other concerns about IP
therapy are difficulties in completing the assigned treatment
and management of its pattern of toxic side-effects. Today,
IP chemotherapy has yet to gain a role as standard first-line
treatment in advanced stage ovarian cancer. In the near
future, efforts should aim at developing an effective IP
regimen and research undertaken for a better understanding of
the peritoneal environment.


--
Matti Narkia
.