Timing is everything: intraperitoneal chemotherapy after primary or interval debulking surgery for advanced ovarian cancer

Purpose To evaluate the outcomes of intraperitoneal chemotherapy (IP) compared with those of intravenous chemotherapy (IV) in patients with advanced ovarian cancer after neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) or primary debulking surgery (PDS). Methods Patients with adv...

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Vydáno v:Cancer chemotherapy and pharmacology Ročník 82; číslo 1; s. 55 - 63
Hlavní autoři: Lee, Jessica, Curtin, John P., Muggia, Franco M., Pothuri, Bhavana, Boyd, Leslie R., Blank, Stephanie V.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2018
Springer Nature B.V
Témata:
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Cancer Research
Carcinoma, Ovarian Epithelial - drug therapy
Carcinoma, Ovarian Epithelial - pathology
Carcinoma, Ovarian Epithelial - surgery
Chemotherapy
Chemotherapy, Adjuvant
Cytoreduction Surgical Procedures
Drug Administration Schedule
Female
Humans
Injections, Intraperitoneal
Injections, Intravenous
Intravenous administration
Intravenous therapy
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Oncology
Original Article
Ovarian cancer
Ovarian carcinoma
Pharmacology/Toxicology
Progression-Free Survival
Surgery
Survival
Survival Rate
Neoadjuvant chemotherapy
Intravenous chemotherapy
Platinum chemotherapy
Primary debulking surgery
Intraperitoneal chemotherapy
Ovarian cancer
ISSN:0344-5704, 1432-0843, 1432-0843
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Shrnutí:Purpose To evaluate the outcomes of intraperitoneal chemotherapy (IP) compared with those of intravenous chemotherapy (IV) in patients with advanced ovarian cancer after neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) or primary debulking surgery (PDS). Methods Patients with advanced epithelial ovarian carcinoma treated with PDS or NACT and IDS from 2006 to 2015 were identified. Comparative statistics were used to evaluate covariates, and survival rates were calculated using the Kaplan–Meier method and compared with log-rank tests. Results Sixty-six patients received NACT followed by IDS with residual disease of ≤ 1 cm; 42 of these patients (63.6%) received IP therapy; and 24 patients (36.3%) had IV therapy only after IDS. The median progression-free survival (PFS) was 16.0 months in the IP group and 13.5 months in the IV group ( p  = 0.13). The estimated median overall survival (OS) was 64.0 months with IP and 50.0 months with IV ( p  = 0.44). During the same study period, 149 patients underwent optimal PDS after which 93 patients (62.4%) received IP and 56 patients (37.6%) were given IV chemotherapy. Patients after IP demonstrated improved survival outcomes when compared to patients after IV therapy. The median PFS was 28.0 months after IP and 16.5 months after IV ( p  = 0.0006), and the median OS was not reached for IP and 50.0 months after IV ( p  < 0.0001). Conclusions Although IP chemotherapy after PDS is associated with improved survival, IP therapy after NACT and IDS, despite high rates of completion, may not have the same degree of survival advantage over IV therapy.
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ISSN:0344-5704
1432-0843
1432-0843
DOI:10.1007/s00280-018-3591-y