Intraperitoneal chemotherapy for ovarian cancer

In this chapter, the authors review the rationale behind intraperitoneal (IP) chemotherapy specifically as it pertains to ovarian cancer and the data that support its use. They discuss limitations to its widespread adoption and future directions aimed at improving tolerability, acceptance, and efficacy of IP chemotherapy in ovarian cancer. IP chemotherapy has been proposed as a mechanism to achieve higher IP concentrations of cytotoxic agents in an attempt to improve progression-free and overall survival. Cisplatin administered intraperitoneally requires both pre- and posttreatment hydration, which increases chair time. Future studies will continue to evaluate mechanisms to optimize patient outcomes with IP chemotherapy. In January of 2006, the US National Cancer Institute issued a clinical alert strongly encouraging the use of IP chemotherapy in stage III epithelial ovarian cancer patients who were optimally cytoreduced. Development of an outpatient regimen of IP chemotherapy may improve the cost effectiveness of IP chemotherapy if proven as effective as the current regimen.