Does Intraperitoneal Therapy for Ovarian Cancer Have a Future?
Ovarian cancer has a unique pattern of spread, with the majority of disease limited to the peritoneal cavity. Intraperitoneal (IP) delivery of chemotherapeutic agents allows for a higher local concentration of drug for a more prolonged period of time at the major site of disease, providing a rationale for its use in ovarian cancer, although limited by poor penetration of tumor implants. This approach is supported by multiple clinical trials demonstrating improved outcomes for ovarian cancer patients but with uncertainty regarding the optimal selection and scheduling of specific agents. Additional challenges to the adoption of IP therapy include the requirement for initial optimal cytoreductive surgery, experience with catheter placement, staff expertise, and the management of treatment-related toxicity. Nonetheless, the improved survival justifies consideration of IP therapy in appropriate patients. Multiple approaches to decrease toxicity, improve tolerability, and indentify key treatment components are currently being evaluated.
KeywordsOverall Survival Ovarian Cancer Cytoreductive Surgery Gynecologic Oncology Group Microscopic Residual Disease
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