Abdominal 'Chemo Bath' May Extend Survival in Ovarian Cancer Patients

Long-term study found women who received 'intraperitoneal' treatment lived about a year longer

By Denise Mann

HealthDay Reporter

SATURDAY, March 9 (HealthDay News) -- Women with advanced ovarian cancer who receive intense chemotherapy directly into their stomach area may live at least one year longer than women who receive standard intravenous chemotherapy, a new study says.

But this survival edge may come at the expense of more side effects.

"The long-term benefits are pretty significant," said study author Dr. Devansu Tewari, director of gynecologic oncology at the Southern California Permanente Medical Group, in Orange County. "There is no study of ovarian cancer treatments that has shown a greater survival advantage."

Intraperitoneal chemotherapy involves bathing the abdominal area with chemotherapy agents. By contrast, intravenous (IV) chemotherapy is delivered throughout the body via the bloodstream. The U.S. National Cancer Institute currently recommends intraperitoneal therapy for women with ovarian cancer who have had successful surgery to remove the tumor.

The 10-year follow-up data from two studies of nearly 900 women with advanced ovarian cancer will be presented Saturday at the annual meeting of the Society of Gynecologic Oncology, in Los Angeles.

In 2013, more than 22,000 American women will be diagnosed with ovarian cancer, and more than 14,000 will die from the disease, according to the U.S. National Cancer Institute. There are no early screening tests for ovarian cancer, which is why it is often diagnosed when the cancer has already spread outside of the ovaries. For this reason, survival rates tend to be very low.

In the new study, women who received the intraperitoneal treatment were 17 percent more likely to survive longer than those who got IV chemotherapy. On average, women in the intraperitoneal group survived for more than five years, while those who received IV chemotherapy survived for about four years, the study found.

But survival benefits aside, intraperitoneal chemotherapy does confer a greater risk of side effects -- such as abdominal pain and numbness in the hands and feet -- and not all women can tolerate this high concentration of cancer-killing drugs. The drugs are also absorbed more slowly, providing more exposure to the medicine. The same properties that make the intraperitoneal therapy more effective likely play a role in causing more side effects, the researchers said.

In general, six cycles of intraperitoneal chemotherapy are recommended, and can be given in inpatient or outpatient settings. The more cycles the women completed, the greater their survival advantage, the study showed. After five years, close to 60 percent of women who completed five or six cycles of intraperitoneal therapy were still alive, compared with 33 percent of those who completed three or four cycles and 18 percent of those who completed one or two cycles. Women can switch back to IV chemotherapy if the side effects prove too harsh. Still, the researchers said, some intraperitoneal chemotherapy is better than none.

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