Combined Drug Method Best for Ovarian Cancer

A large clinical trial has shown that chemotherapy delivered into the abdomen increases survival in some women with advanced ovarian cancer by about one year.

The investigators randomly grouped women with newly diagnosed stage III ovarian cancer into two categories: those who would get all chemotherapy intravenously or those who would get chemotherapy both intravenously and intraperitoneal (IP) through a catheter inserted directly into the abdomen. The results, from a seven-year study of more than 400 patients, were reported in the January 5, 2006, issue of The New England Journal of Medicine.

"The catheter allows us to bathe the entire abdominal area with a high concentration of chemotherapy for a long period of time, which appears to be better at destroying lingering cancer cells,” said principal investigator Deborah Armstrong, M.D., associate professor at the Johns Hopkins Kimmel Cancer Center (Baltimore, MD, USA). According to Dr. Armstrong, the intravenous round of chemotherapy is needed to catch cancer cells that may have spread outside the abdomen.

However, side effects such as suppressed blood counts and neurologic problems were significantly worse for the group receiving abdominal chemotherapy, and they reported poorer quality of life during their treatment. Patients with adhesions or surgical complications, poor kidney function, and those who have had the left side of their colon removed during surgery are not good candidates for IP chemotherapy. Only 86 of the 205 patients enrolled for the abdominal therapy were able to complete the course.

"Women who recived IP chemotherapy had more side effects than those treated with IV chemotherapy alone, but most side effects were temporary and easily managed. One year after treatment, women in both study groups had the same reported quality of life,” noted Dr. Armstrong.

Based on study's findings, new clinical guidelines recommend that women with advanced ovarian cancer who undergo effective surgical debulking receive a combination of intravenous (IV) and IP chemotherapy.




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