What is the role of intraperitoneal (IP) chemotherapy in the treatment of stage III ovarian cancer?

Updated: Dec 06, 2018
  • Author: Shannon M Grabosch, MD; Chief Editor: from Memorial Sloan-Kettering - Yukio Sonoda, MD  more...
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Answer

Answer

Intraperitoneal (IP) chemotherapy remains the preferred treatment for optimally debulked (< 1 cm) stage III ovarian cancer after front-line surgery. A Gynecological Oncology Group trial (GOG 172) that compared IV cisplatin and IV paclitaxel with IP cisplatin and IV/IP paclitaxel determined that IP therapy improved survival and yielded a 25% reduction in the risk of death. However, the trial also showed increased toxicity with IP chemotherapy versus IV chemotherapy. [10]

The recently reported preliminary results of GOG 252 are somewhat contradictory, with no significant difference in progression-free survival (PFS) between patients receiving IV carboplatin/weekly IV paclitaxel; IP carboplatin/weekly IV paclitaxel; or sequential IV paclitaxel, IP cisplatin (dosed at 75 mg/m2), and IP paclitaxel. However, the 28% crossover rate from IP treatment to the IV-only group may have watered down a significant difference in PFS. [11] Furthermore, the addition of bevacizumab to all arms in the study may have contributed to the unexpected results.  Overall survival data have not yet matured.


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