Abdominal Chemotherapy May Improve Survival in Women With Ovarian Cancer
Currently, the best treatment for ]]>ovarian cancer]]> is a combination of surgery to remove the tumor and ]]>chemotherapy]]> . The standard chemotherapy treatment for ovarian cancer in the U.S. is chemotherapy drugs (a platinum analogue and paclitaxel) given through an intravenous needle. But two randomized trials explore the possibility that a combination of intravenous and intraperitoneal chemotherapy, in which chemotherapy is administered directly into the abdominal cavity, may be superior to intravenous therapy alone.
In an article published in the January 5, 2006 issue of the New England Journal of Medicine , researchers report that, compared with standard intravenous chemotherapy, the combination of intravenous and intraperitoneal chemotherapy improved survival in women with advanced ovarian cancer.
About the Study
This study included 415 women who had undergone surgery for advanced (stage III) ovarian cancer. Half of the women were assigned to receive intravenous paclitaxel and the platinum analogue cisplatin (standard treatment), and the other half were assigned to receive intravenous paclitaxel followed by intraperitoneal cisplatin (intraperitoneal treatment). These treatments were administered every three weeks for six cycles. The researchers followed the women to determine how the chemotherapy regimens affected survival.
The average overall survival in the standard treatment group was 49.7 months, compared with 65.6 months in the intraperitoneal treatment group. Women receiving intraperitoneal treatment had a 23% reduced risk of cancer recurrence and a 27% reduced risk of death compared with those receiving standard treatment. Significantly more women in the intraperitoneal treatment group experienced severe or life-threatening toxic effects (e.g., fatigue, pain, gastrointestinal problems). Furthermore, women receiving intraperitoneal treatment reported worse quality of life during and 3-6 weeks after treatment, but there were no significant quality-of-life differences between the groups one year after treatment.
How Does This Affect You?
This study adds to other evidence that suggests standard treatment for women with advanced ovarian cancer should include intraperitoneal chemotherapy. According to the authors of this study, although intraperitoneal therapy is associated with an increased risk of toxic effects and reduced quality of life during treatment, “these results should encourage the use of intraperitoneal chemotherapy in patients with advanced ovarian cancer.” If fact, based on these results most cancer specialists are expected to begin offering this treatment to many of their ovarian cancer patients.
If you are diagnosed with advanced ovarian cancer, talk to your physician about the possibility of incorporating intraperitoneal chemotherapy into your treatment plan. Certain people are not good candidates for this type of treatment, so it is important to carefully weigh your personal risks and benefits before proceeding with any treatment plan.
American Cancer Society
National Cancer Institute
Armstrong DK, Bundy B, Wenzel L, et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. NEJM . 2006;354(1):34-43.
How many women get ovarian cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_How_many_women_get_ovarian_cancer_33.asp?sitearea= . Accessed January 10, 2006.
Last reviewed January 12, 2006 by ]]>Richard Glickman-Simon, MD]]>
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