The use of intraperitoneal chemotherapy for advanced ovarian cancer – The experience of a tertiary referral centre

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY Australian & New Zealand Journal of Obstetrics & Gynaecology Pub Date : 2023-11-22 DOI:10.1111/ajo.13767

Leon Foster, Christina Girgis, Adrienne Kirby, Paul Harnett, Alison Brand

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Abstract

Background

Platinum-based chemotherapy is the backbone of the medical management of ovarian cancer. The dose, route and timing of treatment are ongoing areas of debate. Intraperitoneal (IP) chemotherapy is an alternative delivery method treatment to the conventional intravenous (IV) route for patients with epithelial ovarian cancer, with efficacy supported by Level 1 evidence.

Aims

To compare the outcomes and feasibility of IP to IV delivery of platinum-based chemotherapy in patients with advanced epithelial ovarian cancer.

Materials and Methods

In a single institution, patients receiving adjuvant chemotherapy (IP and IV) for Stages III and IV epithelial ovarian cancer over the period January 2006–December 2018 were identified through a prospectively maintained database. All patients with an IP port inserted were included. A control group of patients treated with IV chemotherapy was created using criteria identified during the study and in the randomised trials that tested IP chemotherapy. Assessments were made for relapse-free survival (RFS) and overall survival (OS) for each cohort.

Results

A total of 639 patients received adjuvant chemotherapy (73 IP and 566 IV) during the study period. Both the IP group and matched IV control group (65 patients) had a median RFS of 26 months. The median OS in the IP group was 63.9 months, and in the IV group was 57.2 months. At ten years, a significantly higher proportion of patients were alive in the IP group cohort (16% vs 3%, relative risk 5.5, 95% CI 1.29–24, P = 0.012). IP chemotherapy was well tolerated by our cohort. In the IP group, 73% had four or more IP cycles and 99% received six or more cycles of chemotherapy.

Conclusions

Our cohort had a high rate of completion of IP chemotherapy with excellent rates of completion of six cycles of any treatment. The RFS and OS in the IP chemotherapy group were comparable to each other and reflected those in the published literature. A significantly higher proportion of patients in the IP cohort were alive at ten years than in the IV cohort.

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使用腹腔化疗晚期卵巢癌-三级转诊中心的经验。

背景:铂类化疗是卵巢癌医学管理的支柱。治疗的剂量、途径和时间是目前存在争议的领域。腹腔化疗(IP)是传统静脉(IV)途径治疗上皮性卵巢癌患者的替代给药方法，其疗效得到1级证据的支持。目的:比较晚期上皮性卵巢癌患者口服给药与静脉给药铂基化疗的疗效和可行性。材料和方法:在单一机构中，通过前瞻性维护的数据库确定2006年1月至2018年12月期间接受III期和IV期上皮性卵巢癌辅助化疗(IP和IV)的患者。所有植入IP端口的患者均纳入研究。根据研究期间确定的标准和测试IP化疗的随机试验中确定的标准，创建了接受静脉化疗治疗的对照组。评估每个队列的无复发生存期(RFS)和总生存期(OS)。结果:研究期间共639例患者接受了辅助化疗(IP 73例，IV 566例)。IP组和匹配的静脉注射对照组(65例)的中位RFS为26个月。IP组的中位OS为63.9个月，IV组为57.2个月。10年时，IP组患者的生存率显著高于对照组(16% vs 3%，相对危险度5.5,95% CI 1.29-24, P = 0.012)。我们的队列对IP化疗耐受良好。在IP组中，73%的患者有4个或更多的IP周期，99%的患者接受了6个或更多的化疗周期。结论:我们的队列有很高的IP化疗完成率，任何治疗的6个周期的完成率都很好。IP化疗组的RFS和OS具有可比性，反映了已发表的文献。与IV组相比，IP组患者在10年时存活的比例明显更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian & New Zealand Journal of Obstetrics & Gynaecology 医学-妇产科学

CiteScore

3.40

自引率

11.80%

发文量

165

审稿时长

4-8 weeks

期刊介绍： The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.