Intraperitoneal chemotherapy in ovarian cancer (Chimiothe?rapie intrape?ritone?ale dans les cancers de l'ovaire)

摘要

Due to the predominance of peritoneal relapses in the evolution of ovarian cancer, intraperitonial (IP) chemotherapy was the object of sustained interest in the 1980s before becoming obsolete. Recently in France intraperitoneal hyperthermic chemotherapy (IPHC) has been put to the forefront, despite the absence of controlled data evaluating the role of hyperthermia, a technique not void of toxicity. In January 2006 the NCI published a recommendation inciting patients with ovarian cancer to receive IP chemotherapy after an initial optimal intervention. This recommendation came further to the publication of the final results of the last three randomised trials from the US which evaluated the role of IP. In a homogenous way they show a diminution of 20-25% of the risk of death when cisplatin is administered IP rather than IV. A high toxicity was the price to pay for these benefits not only due to complications with the method of administration, but also haematological, renal and neurological complications when cisplatin IP is associated with paclitaxel IV. A strict selection of patients is thus necessary before proposing cisplatin-based first-line chemotherapy. Springer 2006.