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Comparative Study
. 2017 Dec;32(12):2021-2028.
doi: 10.3346/jkms.2017.32.12.2021.

Long-Term Survival Analysis of Intraperitoneal versus Intravenous Chemotherapy for Primary Ovarian Cancer and Comparison between Carboplatin- and Cisplatin-based Intraperitoneal Chemotherapy

Kyung Jin Eoh  1 , Jung Yun Lee  1 , Eun Ji Nam  1 , Sunghoon Kim  1 , Young Tae Kim  1 , Sang Wun Kim  2
Affiliations
Comparative Study

Long-Term Survival Analysis of Intraperitoneal versus Intravenous Chemotherapy for Primary Ovarian Cancer and Comparison between Carboplatin- and Cisplatin-based Intraperitoneal Chemotherapy

Kyung Jin Eoh et al. J Korean Med Sci. 2017 Dec.

Abstract

In epithelial ovarian cancer (EOC), intraperitoneal (IP) administration of chemotherapy is an effective first-line treatment and may improve outcomes, compared with intravenous (IV) chemotherapy. We used Kaplan-Meier survival analysis to compare long-term survival between propensity score-matched patients with advanced EOC receiving IP (n = 34) vs. IV (n = 68) chemotherapy. Additionally, clinical features associated with carboplatin-based (n = 21) and cisplatin-based (n = 16) IP chemotherapy were analyzed and compared with those associated with IV chemotherapy. The IP and IV chemotherapy groups had a median follow-up duration of 67 (range, 3-131) and 62 (range, 0-126) months, respectively, with no significant difference in progression-free survival (PFS) (P = 0.735) and overall survival (OS) (P = 0.776). A significantly higher proportion of patients in the IV (91.2%) than in the IP (67.6%) chemotherapy group (P = 0.004) received ≥ 6 cycles. However, the frequency of toxic events (anemia, granulocytopenia, nausea/vomiting, abdominal pain, hepatotoxicity, neuromuscular effects) was significantly higher in the IP than in the IV group. Within the IP group, no significant differences were observed in PFS (P = 0.533) and OS (P = 0.210) between the cisplatin-based and carboplatin-based chemotherapy subgroups. The 10-year OS was 28.6% and 49.2% in carboplatin-based and cisplatin-based IP chemotherapy groups, respectively. Toxic events (granulocytopenia, leukopenia, nausea/vomiting, abdominal pain, hepatotoxicity, neuromuscular effects) were significantly more common in the cisplatin-based subgroup. In patients with EOC, cisplatin-based IP chemotherapy may be an acceptable alternative to IV chemotherapy regarding long-term survival, but toxicity must be addressed.

Keywords: Carboplatin; Intraperitoneal Chemotherapy; Ovarian Cancer; Survival.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Flowchart of patient selection. EOC = epithelial ovarian cancer, pts = patients, PDS = primary debulking surgery, NAC = neoadjuvant chemotherapy, CTx = chemotherapy, IP = intraperitoneal, IV = intravenous.
Fig. 2
Fig. 2
Comparison of survival outcomes between IP and IV chemotherapy groups. (A) PFS according to treatment intention in patients with advanced EOC treated with IP or IV chemotherapy. (B) OS according to treatment intention in patients with advanced EOC treated with IP or IV chemotherapy. IP = intraperitoneal, IV = intravenous, PFS = progression-free survival, EOC = epithelial ovarian cancer, OS = overall survival.
Fig. 3
Fig. 3
Comparison of survival outcomes between cisplatin-based and carboplatin-based IP chemotherapy subgroups. (A) PFS according to treatment intention in patients with advanced EOC treated with IP chemotherapy. (B) OS according to treatment intention in patients with advanced EOC treated with IP chemotherapy. IP = intraperitoneal, IV = intravenous, PFS = progression-free survival, EOC = epithelial ovarian cancer, OS = overall survival.
See this image and copyright information in PMC

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