Intraperitoneal (IP) chemotherapy in ovarian cancer has been studied since 1978. Numerous phase II trials have been performed, which have shown that higher levels can be obtained in the peritoneal cavity compared with systemic circulation after administration of cytoxic agents in a large volume via a semi-permanent catheter. Three randomized trials have been performed in patients with ovarian cancer comparing different IP regimens to standard therapy with intravenous agents. The last two trials from the Gynecologic Oncology Group (GOG) and the Southwest Oncology Group (SWOG) compared two different IP regimens versus standard therapy with intravenous cisplatin plus paclitaxel. Although an improvement in progression-free survival was reported for the IP regimens, they have been associated with unacceptable toxicity, and no IP regimen can be considered standard therapy. Maintenance therapy with IP cisplatin also failed to improve survival in patients who obtained complete remission after intravenous chemotherapy. The GOG is considering another phase III trial of IP therapy that will compare a carboplatin-based regimen versus standard therapy with intravenous paclitaxel plus carboplatin. Unless such a trial shows an improvement in clinical outcome, intravenous carboplatin plus paclitaxel remains the standard of care and IP chemotherapy should not be used outside of a clinical trial.
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Robert F. Ozols
F. Anthony Greco
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NCCN Guidelines® Insights: Ovarian Cancer, Version 3.2022
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treatment for advanced invasive thymoma with cisplatin, doxorubicin, and methylprednisolone . J Thorac Oncol 2007 ; 2 : 73 – 78 . 31. Lemma GL Loehrer PJ Sr Lee JW . A phase II study of carboplatin plus paclitaxel in advanced thymoma or thymic
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Bafaloukos D . Carboplatin plus paclitaxel in unknown primary carcinoma: a phase II Hellenic Cooperative Oncology Group study . J Clin Oncol 2000 ; 18 : 3101 – 3107 . 6 Culine S Lortholary A Voigt JJ . Cisplatin in combination with either
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over surgery alone in esophageal and gastroesophageal junction adenocarcinoma and squamous cancer. 45 This trial also used a more contemporary chemotherapy regimen: weekly carboplatin plus paclitaxel. Preoperative therapy conferred a median 2-year
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.1038/nrclinonc.2010.43 20368727 39. Zhang P , Yin Y , Mo H , . Better pathologic complete response and relapse-free survival after carboplatin plus paclitaxel compared with epirubicin plus paclitaxel as neoadjuvant chemotherapy for locally advanced
