Abstract
Objectives. To evaluate reasons for discontinuing intraperitoneal (IP) chemotherapy, and to compare characteristics of patients who did versus did not successfully complete six cycles of IP chemotherapy. Methods. In a phase III trial, women with optimal stage III ovarian or peritoneal carcinoma were randomly allocated to receive IP therapy (paclitaxel 135 mg/m2 intravenously (IV) over 24 h, cisplatin 100 mg/m2 IP day 2, paclitaxel 60 mg/m2 IP day 8) every 21 days for six cycles. Patients unable to receive IP therapy were treated with the alternate (IV) regimen. Variables compared included surgical procedures prior to enrollment, timing of IP catheter insertion, and primary and contributing reasons for discontinuing IP therapy. Results. Among 205 eligible patients randomly allocated to the IP arm, 119 (58%) did not complete six cycles of IP therapy. Forty (34%) patients discontinued IP therapy primarily due to catheter complications and 34 (29%) discontinued for unrelated reasons. Hysterectomy, appendectomy, small bowel resection, and ileocecal resection were not associated with failure to complete six cycles. IP therapy was not initiated in 16% of patients who did versus 5% of those who did not have a left colon or rectosigmoid colon resection (P = 0.015). There was no association between timing of catheter insertion and failure to complete IP therapy. Conclusions. In this multi-institutional setting, it was difficult to deliver six cycles of IP therapy without complications. There appears to be an association between rectosigmoid colon resection and the inability to initiate IP therapy. Catheter choice, timing of insertion, and how surgical treatment of ovarian cancer influences the successful completion of intraperitoneal chemotherapy require further study.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 27-32 |
| Number of pages | 6 |
| Journal | Gynecologic Oncology |
| Volume | 100 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2006 |
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Keywords
- Chemotherapy
- Intraperitoneal
- Ovarian neoplasm
ASJC Scopus subject areas
- Obstetrics and Gynecology
- Oncology
Cite this
Intraperitoneal catheter outcomes in a phase III trial of intravenous versus intraperitoneal chemotherapy in optimal stage III ovarian and primary peritoneal cancer : A Gynecologic Oncology Group study. / Walker, Joan L.; Armstrong, Deborah Kay; Huang, Helen Q.; Fowler, Jeffrey; Webster, Kenneth; Burger, Robert A.; Clarke-Pearson, Daniel.
In: Gynecologic Oncology, Vol. 100, No. 1, 01.2006, p. 27-32.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intraperitoneal catheter outcomes in a phase III trial of intravenous versus intraperitoneal chemotherapy in optimal stage III ovarian and primary peritoneal cancer
T2 - A Gynecologic Oncology Group study
AU - Walker, Joan L.
AU - Armstrong, Deborah Kay
AU - Huang, Helen Q.
AU - Fowler, Jeffrey
AU - Webster, Kenneth
AU - Burger, Robert A.
AU - Clarke-Pearson, Daniel
PY - 2006/1
Y1 - 2006/1
N2 - Objectives. To evaluate reasons for discontinuing intraperitoneal (IP) chemotherapy, and to compare characteristics of patients who did versus did not successfully complete six cycles of IP chemotherapy. Methods. In a phase III trial, women with optimal stage III ovarian or peritoneal carcinoma were randomly allocated to receive IP therapy (paclitaxel 135 mg/m2 intravenously (IV) over 24 h, cisplatin 100 mg/m2 IP day 2, paclitaxel 60 mg/m2 IP day 8) every 21 days for six cycles. Patients unable to receive IP therapy were treated with the alternate (IV) regimen. Variables compared included surgical procedures prior to enrollment, timing of IP catheter insertion, and primary and contributing reasons for discontinuing IP therapy. Results. Among 205 eligible patients randomly allocated to the IP arm, 119 (58%) did not complete six cycles of IP therapy. Forty (34%) patients discontinued IP therapy primarily due to catheter complications and 34 (29%) discontinued for unrelated reasons. Hysterectomy, appendectomy, small bowel resection, and ileocecal resection were not associated with failure to complete six cycles. IP therapy was not initiated in 16% of patients who did versus 5% of those who did not have a left colon or rectosigmoid colon resection (P = 0.015). There was no association between timing of catheter insertion and failure to complete IP therapy. Conclusions. In this multi-institutional setting, it was difficult to deliver six cycles of IP therapy without complications. There appears to be an association between rectosigmoid colon resection and the inability to initiate IP therapy. Catheter choice, timing of insertion, and how surgical treatment of ovarian cancer influences the successful completion of intraperitoneal chemotherapy require further study.
AB - Objectives. To evaluate reasons for discontinuing intraperitoneal (IP) chemotherapy, and to compare characteristics of patients who did versus did not successfully complete six cycles of IP chemotherapy. Methods. In a phase III trial, women with optimal stage III ovarian or peritoneal carcinoma were randomly allocated to receive IP therapy (paclitaxel 135 mg/m2 intravenously (IV) over 24 h, cisplatin 100 mg/m2 IP day 2, paclitaxel 60 mg/m2 IP day 8) every 21 days for six cycles. Patients unable to receive IP therapy were treated with the alternate (IV) regimen. Variables compared included surgical procedures prior to enrollment, timing of IP catheter insertion, and primary and contributing reasons for discontinuing IP therapy. Results. Among 205 eligible patients randomly allocated to the IP arm, 119 (58%) did not complete six cycles of IP therapy. Forty (34%) patients discontinued IP therapy primarily due to catheter complications and 34 (29%) discontinued for unrelated reasons. Hysterectomy, appendectomy, small bowel resection, and ileocecal resection were not associated with failure to complete six cycles. IP therapy was not initiated in 16% of patients who did versus 5% of those who did not have a left colon or rectosigmoid colon resection (P = 0.015). There was no association between timing of catheter insertion and failure to complete IP therapy. Conclusions. In this multi-institutional setting, it was difficult to deliver six cycles of IP therapy without complications. There appears to be an association between rectosigmoid colon resection and the inability to initiate IP therapy. Catheter choice, timing of insertion, and how surgical treatment of ovarian cancer influences the successful completion of intraperitoneal chemotherapy require further study.
KW - Chemotherapy
KW - Intraperitoneal
KW - Ovarian neoplasm
UR - http://www.scopus.com/inward/record.url?scp=29144462090&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=29144462090&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2005.11.013
DO - 10.1016/j.ygyno.2005.11.013
M3 - Article
VL - 100
SP - 27
EP - 32
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 1
ER -