Volume : VI, Issue : XII, December - 2016

Phase II study of Intraperitoneal Chemotherapy in patients with inoperable Ovarian and Primary Peritoneal Cancers

Abdul Majeed K, Ganesants, Pavithran K, Vijaykumar D. K.

Abstract :

 BACKGROUND: Epithelial ovarian cancer is the leading cause of death from gynecologic cancer world wide. As most patients present with advanced disease, chemotherapy is a crucial adjunct to surgical cytoreduction. In the last 10 years, three large prospective phase III clinical trials have shown survival advantages for patients receiving IP versus IV chemotherapy for the treatment of optimally cytoreduced, advanced ovarian cancer. Despite this demonstrated survival advantage, IP chemotherapy continues to await universal acceptance as first–line treatment for advanced epithelial ovarian cancer. PATIENTS AND METHODS: Between November 2007 and June 2009, total of 25 patients with histology proven inoperable stage IIIC or IV epithelial ovarian and primary peritoneal cancers were offered the IP therapy but only 18 patients gave consent for study. The age varied from 29 to 67 median age 54yrs.Selected patients were initially treated with six cycles of systemic chemotherapy with Paclitaxel and Carboplatin, responding patients underwent optimal cytoreductive surgery and catheter placement. Intraperitoneal chemotherapy with cisplatin 75 mg/M2 was given for three cycles every 3 weeks. Patients with catheter block were treated with direct puncture technique. RESULTS : A total of 29 cycles were administered. 14 cycles were given with IP catheter and 15 cycles with direct puncture technique. 8/11 patients received all planned cycles of IP therapy. Major toxicities noticed in patients with IP catheter include blocked catheter, sepsis and abdominal pain. Direct puncture technique was without any toxicity related to the procedure. Quality of life assessment by using global health status scale was better in patients who received IP chemotherapy through direct puncture (n=7) compared to chemotherapy using IP catheter [n=8]. (P value less than 0.001). CONCLUSIONS : Intraperitoneal chemotherapy by direct puncture technique is feasible without any major catheter related toxicities even in the post operative setting after six cycles of chemotherapy. IP therapy by silastic catheter is associated with catheter related toxicities in a majority of patients. IP chemotherapy by Cisplatin can be safely administered on an out patient basis which will reduce the cost of therapy and the need for hospitalization.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Abdul Majeed K, GanesanTS, Pavithran K, Vijaykumar D. K., Phase II study of Intraperitoneal Chemotherapy in patients with inoperable Ovarian and Primary Peritoneal Cancers, Indian Journal of Applied Research,Volume : 6 | Issue : 12 | December 2016

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