Factors affecting the completion of intraperitoneal chemotherapy in women with ovarian cancer.
OBJECTIVE
The use of intraperitoneal (IP) chemotherapy as treatment for ovarian cancer has been demonstrated to result in improved survival. However, it is associated with significant toxicity, resulting in the early discontinuation of therapy in many cases. This report quantifies and analyzes the reasons why patients discontinue therapy before completion and discusses strategies for improvement.


METHODS
One hundred seventy-seven women with ovarian cancer who received IP chemotherapy for a 10-year period at a regional cancer center were followed, and demographic and treatment data were collected. SigmaStat (v2.0) was used to make statistical calculations regarding the data.


RESULTS
One hundred seventy-seven subjects received 915 cycles of IP therapy. One hundred forty subjects received IP chemotherapy as initial treatment. Ninety-five (68%) of the 140 subjects completed 6 planned cycles. Thirty-seven subjects received IP for recurrent disease. Only 14 (38%) of the 37 subjects completed 6 cycles (P = 0.001). The most common reason for noncompletion of IP therapy was port occlusion (39/68 of the patients, 57%). Very few subjects refused treatment (9/68 of the patients, 13%). The rate of completion of therapy improved over time in this program (2001, 36%; 2009, 75%).


CONCLUSIONS
The rate of completion of IP chemotherapy was higher in this institution than in other reports, including randomized multicenter trials. Port occlusion was the most common reason why IP chemotherapy was not completed. Subjective reasons for stopping therapy were rare. The establishment of a comprehensive, coordinated IP administration program is likely to result in improved completion rates. Completion rates within an institution improve with experience as well.
Robinson
William R
WR
1400 Coulter St, Texas Tech University Health Science Center/Amarillo, Amarillo, TX 79106, USA. William.robinson@ttuhsc.edu
Beyer
Julie
J
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002277:Carcinoma / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage; D010349:Patient Compliance / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D028761:Withholding Treatment / Q000706:statistics & numerical data
D017239:Paclitaxel; D002945:Cisplatin