Intraperitoneal plus Intravenous Chemotherapy for Ovarian Cancer Prolongs Survival, but at What Cost?

Conventional chemotherapy for ovarian cancer consists of one cycle of intravenous (IV) carboplatin and paclitaxel every 3 weeks; however, adding intraperitoneal (IP) chemotherapy can prolong median survival (NEJM JW Womens Health Mar 2006 and N Engl J Med 2006; 354:34).

In a study of 5892 women with advanced ovarian cancer who underwent primary debulking surgery followed by chemotherapy, investigators reported that, from 2009 to 2013, only 16% of women received combination IP/IV chemotherapy whereas >65% were treated with conventional IV chemotherapy. Toxicity was significantly greater with IP/IV chemotherapy than conventional chemotherapy, with hospitalizations for chemotherapy-associated complications (including gastrointestinal side effec…