Intraperitoneal chemotherapy for women with advanced ovarian cancer
What is intraperitoneal chemotherapy?
Intraperitoneal chemotherapy (IP) is way of delivering chemotherapy drugs directly into the abdominal cavity - the space between the abdominal organs and the abdominal muscle. The chemotherapy drugs are mixed with fluid and given through a tube (catheter) that can be inserted at the time of the surgery and is connected to a reservoir that sits beneath the skin over the lower ribs. The catheter will need to be removed with an operation at the completion of the course of chemotherapy.
Why use IP?
The abdominal cavity is the most common site of spread or recurrence for ovarian cancer, and IP delivers a more concentrated dose of drugs directly to this site.
What is the difference between IP and the current standard treatment for advanced ovarian cancer?
The standard treatment for women with advanced ovarian cancer is to have their chemotherapy delivered intravenously (IV) through a drip inserted in a vein in the arm.
Does IP replace intravenous chemotherapy?
No. In most cases IP will be used in conjunction with some IV treatment.
How has IP been tested?
IP has been tested in clinical trials where women were randomly chosen to have IV chemotherapy or IV chemotherapy followed by IP chemotherapy.
What are the side effects of IP?
The side effects that can occur directly related to the use of intraperitoneal chemotherapy are: pain from filling the abdominal cavity with fluid, infection in the abdominal cavity or in the implanted catheter, bowel obstruction or perforation of the bowel by the catheter tubing. Nausea and vomiting may occur due to the chemotherapy drug used in the treatment. Some women are unable to continue using IP due to the side effects but clinical trials are underway in Australia looking at ways of reducing the side-effects and improving quality of life for women receiving IP.
Is the treatment suitable for every woman with ovarian cancer?
Based on evidence from clinical trials, IP was shown to be suitable for women with stage III ovarian cancer, where there were tumour masses less than 1cm remaining at the end of surgery and where there were minimal adhesions in the abdomen. This is called optimal cytoreduction. There is no evidence to indicate that having IP will benefit women with early ovarian cancer (stage I or II) or stage IV ovarian cancer. There is no evidence that it is useful treatment for recurrent ovarian cancer
Is IP available at any hospital?
No. IP should only be provided at a gynaecological cancer centre by experienced staff. Your gynaecological oncologist can advise you as to the suitability of the treatment for you and where it can be provided. You may be able to have the treatment as an out-patient, but you will need to remain in bed while the treatment is given.
