Intrapritoneal Chemotherapy

The most common route of ovarian cancer spread is within the peritoneal cavity. The rationale foradministering chemotherapy directly into the peritoneal cavity is supported by preclinical,pharmacokinetic, and pharmacodynamics data. Compared with intravenous (IV) treatment,intraperitoneal (IP) administration permits a several-fold increase in drug concentration to beachieved within the abdominal cavity. In addition, clinical trials have demonstrated a survivaladvantage to the incorporation of IP treatment in the upfront management of ovarian cancer Basedon available clinical data, intraperitoneal (IP) chemotherapy may be most useful in women withoptimally debulked (to ≤1.0 cm) stage III epithelial ovarian cancer (EOC). Some patients withearlier-stage disease may also be candidates Those patients who have been cytoreduced to no grossresidual disease seem to have the greatest benefit from IP chemotherapy and improved overallsurvival. Furthermore, some experts also utilize IP chemotherapy for women treated withneoadjuvant chemotherapy who undergo an optimal interval cytoreduction.