Intraperitoneal chemotherapy for ovarian cancer
Affiliation and adress for correspondence

Katedra i Klinika Ginekologii i Ginekologii Onkologicznej Gdańskiego Uniwersytetu Medycznego. Kierownik Kliniki: dr n. med. Dariusz Wydra
Correspondence to: Tomasz Milczek, Katedra i Klinika Ginekologii i Ginekologii Onkologicznej Gdańskiego Uniwersytetu Medycznego,
ul. Kliniczna 1 A, 80-402 Gdańsk, e-mail: tomasz@milczek. com
Source of financing: Department own sources

CURR. GYNECOL. ONCOL. 2009, 7 (4), p. 270-281
ABSTRACT

The paper is a detailed review of recent advances in the treatment of ovarian cancer patients using intraperitoneal chemotherapy. Theoretical basis of intraperitoneal treatment is discussed, this being understood as passage of substances through semipermeable membrane, where rate of passage depends on peritoneal clearance, size and electric charge of particles and concentration gradient. History of intraperitoneal treatment is reviewed, starting with early works by Green and Kottmeier dating back to the ‘50s, and ending with recent studies, including a meta-analysis of 8 randomized trials of first-line treatment published within the past 12 years, which included a total of 1819 patients. The authors discuss reasons for issuing pertinent recommendations by the US National Cancer Institute, emphasizing the leading role of intraperitoneal chemotherapy in the treatment of ovarian cancer patients. Effectiveness of platinum derivates-based chemotherapy in consolidation treatment is discussed, supported by a review of pivotal papers concerning this subject. The paper presents and discusses key reports on implementation of intraperitoneal chemotherapy in consecutive lines of treatment of ovarian cancer, as well as the role of cisplatin and carboplatin in intraperitoneal therapy, highlighting differences in outcome after application of both agents. Emphasized are also limitations of the method. Next, the authors review surgical complications arising during procedures associated with implementation of intraperitoneal chemotherapy, as well as several aspects of complications resulting in premature interruption of intraperitoneal chemotherapy (on the average: 50% of cases; up to 60% in the GOG 172 trial). Critique of the method, mainly on the part of European centers, is referred to.

Keywords: ovarian cancer, chemotherapy, intraperitoneal chemotherapy, IPC, IP