Role of Intraperitoneal Therapy in the Initial Management of Ovarian Cancer
Ce dossier fait le point sur les avancées en matière de traitement des cancers gynécologiques
For women with optimally debulked ovarian cancer, a major controversy concerns the route, intravenous (IV) or intraperitoneal (IP), by which chemotherapy is optimally administered. A major rationale for IP therapy is that the largest volume of disease in advanced ovarian cancer is frequently within the peritoneal cavity, and treatment can be focused there with IP treatment. Pharmacologic data show that, compared with IV treatment, IP administration will result in a several-fold increase in drug concentration in the abdominal cavity for many drugs active in the treatment of ovarian cancer, including cisplatin, carboplatin, paclitaxel, and docetaxel. In addition, drug clearance from the peritoneal cavity is significantly slower than from the vascular compartment, resulting in prolonged duration of drug exposure.1 In most instances, treatment regimens using IP therapy also include IV therapy to ensure therapeutic systemic exposure to anticancer therapy. These regimens are referred to as IV/IP.