Cancer Treatment Today

Intravenous, or IV administration, of chemotherapy drugs is done by inserting a needle into a vein in the body, usually in the arm. Intraperitoneal or IP administration of chemotherapy, usually is done through a surgically implanted catheter, which is a hollow, flexible tube that allows passage of fluids into the abdomen of a woman with ovarian cancer. The Gynecologic Oncology Group (GOG) undertook GOG-172 to see whether the improvement in survival noted with IP treatment in other studies was still seen when paclitaxel was given with a platinum drug. GOG conducted a randomized phase III trial to compare a standard regimen of intravenous paclitaxel and cisplatin to an intensive regimen of intravenous paclitaxel and sequential intraperitoneal cisplatin and paclitaxel in previously untreated stage III ovarian cancer. Patients who received part of their chemotherapy via an IP route had a median survival time of 16 months longer than women who received only IV chemotherapy. The 205 women treated via the IP route fared better, even though most of them received fewer doses than the planned. There are also studies that support IP therapy alone. There were no significant quality-of-life differences between the arms one year after treatment. Compared with standard intravenous paclitaxel plus cisplatin, an intensive regimen of intravenous paclitaxel plus sequential intraperitoneal cisplatin and paclitaxel significantly improved progression-free and overall survival in patients with optimally debulked stage III ovarian cancer. This patient had stage IIC but some guidelines include stage II as well. NCCN recommends everal options for stage II ovarian cancer, one of them is IP taxol/cisplatin.

NCCN, Ovarian 2016

P. Dubé , et al, Practice Guideline  Guidelines on the use of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with peritoneal surface malignancy arising from colorectal or appendiceal neoplasms Current Oncology Vol 22, No 2 (2015)

Guideline Summary
NGC:010253
2010 Jul (revised 2013 Apr) Epithelial ovarian, fallopian tube, and primary peritoneal cancer.

Jaaback K, Johnson N. Intraperitoneal chemotherapy for the initial management of primary epithelial ovarian cancer. Cochrane Database of Systematic Reviews 2007, Issue 1

Elit L, Oliver T, Covens A, Kwon J, Fung-Kee-Fung M, Hirte H, Oza A, Gynecology Cancer Disease Site Group. The role of intraperitoneal chemotherapy in the first-line treatment of women with stage III epithelial ovarian cancer: a clinical practice guideline. Toronto (ON): Cancer Care Ontario (CCO); 2006 Aug 3. 23 p. (Evidence-based series; no. 4-21). [26 references]