Toxicity of intraperitoneal chemotherapy and risk factors for severe toxicity in optimally debulked ovarian cancer patients

Taiwan J Obstet Gynecol. 2015 Jun;54(3):275-9. doi: 10.1016/j.tjog.2013.12.010.

Abstract

Objective: To assess the effect and toxicity of intraperitoneal (IP) chemotherapy for epithelial ovarian cancer and to determine the risk factors for severe toxicity.

Materials and methods: Patients who received IP chemotherapy after optimal debulking surgery for ovarian cancer between 2006 and 2012 were retrospectively reviewed. Clinical characteristics were compared between patients with none/Grade 1 or Grade 2 toxicity and those with Grade 3 or Grade 4 toxicity.

Results: In 41 patients, the mean number of IP cycles administered was 5.6 and most patients (80.5%) completed at least six cycles. The reasons for discontinuation were catheter-related problems (30%), disease progression (20%), or drug-related adverse effects (30%). Grade 3 or Grade 4 toxicity was observed in 30 patients (73.2%). The rate of neoadjuvant chemotherapy was higher in the patients with Grade 3 or Grade 4 toxicity (37%) than in the patients without Grade 3 or Grade 4 toxicity (9%), however, this difference was not significant (p = 0.128). During a mean follow-up period of 33.6 months, tumor recurrence occurred in 20 (48.8%) patients and the median progression-free survival was 30.0 months.

Conclusion: Despite the high rate of adverse events, IP chemotherapy can be delivered with a high completion rate and manageable toxicity to patients with optimally debulked ovarian cancer. Toxicity should be closely monitored in patients who have received neoadjuvant chemotherapy until a large prospective study can be performed to determine its influence.

Keywords: intraperitoneal chemotherapy; ovarian cancer; toxicity of chemotherapy.

MeSH terms

  • Adult
  • Anemia / chemically induced
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Carboplatin / administration & dosage
  • Carboplatin / adverse effects
  • Carcinoma, Ovarian Epithelial
  • Catheter Obstruction
  • Catheters, Indwelling / adverse effects
  • Chemotherapy, Adjuvant / adverse effects
  • Chemotherapy-Induced Febrile Neutropenia / etiology
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Cytoreduction Surgical Procedures
  • Diarrhea / chemically induced
  • Disease-Free Survival
  • Female
  • Humans
  • Ileus / chemically induced
  • Infusions, Parenteral
  • Middle Aged
  • Nausea / chemically induced
  • Neoadjuvant Therapy / adverse effects
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasms, Glandular and Epithelial / drug therapy*
  • Neoplasms, Glandular and Epithelial / surgery
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / surgery
  • Paclitaxel / administration & dosage
  • Paclitaxel / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Vomiting / chemically induced
  • Withholding Treatment

Substances

  • Carboplatin
  • Paclitaxel
  • Cisplatin