title: Intraperitoneal chemotherapy for patients with advanced epithelial ovarian cancer: a review of complications and completion rates.
abstract: OBJECTIVE
  Intraperitoneal (i.p.) chemotherapy has a clear survival advantage in patients with advanced ovarian cancer, but the high rate of complications has discouraged widespread acceptance. The purpose of this study was to review the completion rate of patients receiving i.p. chemotherapy as first line treatment at a single institution and determine what factors prohibit completion of therapy.
  
  
  METHODS
  Patients receiving i.p. chemotherapy from 1993 to 2006 were identified by hospital registries for a retrospective review. Charts were abstracted for patient demographics, clinical and pathologic findings, surgical intervention, treatment modalities, and toxicity.
  
  
  RESULTS
  Eighty-three patients were identified who received front line treatment with i.p. chemotherapy. All patients received a platinum and taxane agent. Port placement (single lumen, venous access device) was completed at time of cytoreductive surgery (33%, n=27) or by mini-laparotomy (67%, n=56). Fifty patients (60%) completed a minimum of 6 cycles of treatment with a mean of 5 cycles. Eleven patients (13%) discontinued treatment due to catheter-related complications including infection (n=4), access difficulties (n=3), grade 4 abdominal pain (n=1), port leaking (n=1), and development of a peritoneal-vaginal fistula (n=1). Sixteen patients (19%) did not complete i.p. treatment because of chemotherapy-related toxicity. The remaining six patients did not complete chemotherapy due to disease progression or other reasons unrelated to modality of treatment.
  
  
  CONCLUSIONS
  Few catheter-related complications were encountered in a review of front-line i.p. chemotherapy administration at a single institution using a single lumen venous access device. The majority of failures were due to persistent grade 3-4 chemotherapy toxicity. i.p. chemotherapy can be safely administered by a dedicated health-care team committed to i.p. chemotherapy as a front-line treatment.
authors.affiliation: Section of Gynecology Oncology, Department of Obstetrics & Gynecology, University of Oklahoma Health Sciences Center, P.O. Box 26901, WP 2410, Oklahoma City, OK 73190, USA. Lisa-landrum@ouhsc.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Landrum
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gold
authors.forename: Kathleen N
authors.initials: KN
authors.lastname: Moore
authors.forename: Tashanna K N
authors.initials: TK
authors.lastname: Myers
authors.forename: D S
authors.initials: DS
authors.lastname: McMeekin
authors.forename: Joan L
authors.initials: JL
authors.lastname: Walker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D010349:Patient Compliance; D012189:Retrospective Studies
chemical_list: D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin