Intraperitoneal chemotherapy in patients pretreated for ovarian cancer matched with patients treated with parenteral chemotherapy

Maria Ornella Nicoletto, Alessandra Casarin, Alessandra Baldoni, Eliana Rulli, Giulia Tasca, Zora Baretta, Grazia Artioli, Giuseppe Lombardi, Alessandro Cappetta, Irene Floriani, Giovanni Randon, Sara Valpione, Piero Litta, Pierfranco Conte, Simone Mocellin, Camillo Aliberti

Research output: Contribution to journalArticle

Abstract

Background: Our aim was to analyze the impact of intraperitoneal chemotherapy (IPC), administered with direct peritoneal puncture, on the survival of patients with pretreated ovarian cancer in a real-life setting. Patients and Methods: This was a retrospective study comparing patients with advanced ovarian cancer treated with IPC (N=33) and patients treated with standard intravenous (i.v.) chemotherapy matching cases for known prognostic factors (age, platinum sensitivity, histological subgroup and grade). Data were then analyzed for survival with nested Cox multivariate regression. Results: The case matching resulted in two homogeneous cohorts by age, platinum sensitivity, resistance to therapy and histology. When analyzed by hazard ratio (HR), the number of previous treatments and IPC vs. i.v. therapy were significant (HR=1.97 for i.v. and HR=1.90 for each incremental previous treatment line, multivariate p<0.001). When analyzing the patients with fewer than three previous treatment lines, IPC conferred a survival advantage of about 2.2 months (IPC=10.0 vs. i.v.=7.8 months, p=0.011). However, the survival advantage in heavily pre-treated patients (with three or more previous treatments) was not significant. One case, pre-treated with more lines of chemotherapy, with renal failure after intraperitoneal cisplatin was followed by death. None of the patients had bowel subocclusions and we recorded a lower incidence of local toxicity, such as cellulite, with IPC (two out of 33 cases). Two patients thereafter refused IPC due to abdominal pain. Conclusion: Our findings confirm that IPC is an effective approach compared to systemic chemotherapy for advanced ovarian cancer, even in pre-treated patients, including platinum-resistant cases. The survival benefit appears to be confined to non-heavily treated patients. Overall, direct intraperitoneal drug injection (without permanent devices) appears to be feasible, safe and possibly advantageous.

Original languageEnglish
Pages (from-to)6541-6546
Number of pages6
JournalAnticancer Research
Volume36
Issue number12
DOIs
Publication statusPublished - Dec 1 2016

    Fingerprint

Keywords

  • Intraperitoneal treatment
  • Parenteral chemotherapy
  • Pretreated ovarian cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Nicoletto, M. O., Casarin, A., Baldoni, A., Rulli, E., Tasca, G., Baretta, Z., Artioli, G., Lombardi, G., Cappetta, A., Floriani, I., Randon, G., Valpione, S., Litta, P., Conte, P., Mocellin, S., & Aliberti, C. (2016). Intraperitoneal chemotherapy in patients pretreated for ovarian cancer matched with patients treated with parenteral chemotherapy. Anticancer Research, 36(12), 6541-6546. https://doi.org/10.21873/anticanres.11256