title: Toxicity of intraperitoneal chemotherapy and risk factors for severe toxicity in optimally debulked ovarian cancer patients.
abstract: OBJECTIVE
  To assess the effect and toxicity of intraperitoneal (IP) chemotherapy for epithelial ovarian cancer and to determine the risk factors for severe toxicity.
  
  
  METHODS
  Patients who received IP chemotherapy after optimal debulking surgery for ovarian cancer between 2006 and 2012 were retrospectively reviewed. Clinical characteristics were compared between patients with none/Grade 1 or Grade 2 toxicity and those with Grade 3 or Grade 4 toxicity.
  
  
  RESULTS
  In 41 patients, the mean number of IP cycles administered was 5.6 and most patients (80.5%) completed at least six cycles. The reasons for discontinuation were catheter-related problems (30%), disease progression (20%), or drug-related adverse effects (30%). Grade 3 or Grade 4 toxicity was observed in 30 patients (73.2%). The rate of neoadjuvant chemotherapy was higher in the patients with Grade 3 or Grade 4 toxicity (37%) than in the patients without Grade 3 or Grade 4 toxicity (9%), however, this difference was not significant (p = 0.128). During a mean follow-up period of 33.6 months, tumor recurrence occurred in 20 (48.8%) patients and the median progression-free survival was 30.0 months.
  
  
  CONCLUSIONS
  Despite the high rate of adverse events, IP chemotherapy can be delivered with a high completion rate and manageable toxicity to patients with optimally debulked ovarian cancer. Toxicity should be closely monitored in patients who have received neoadjuvant chemotherapy until a large prospective study can be performed to determine its influence.
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Guro Hospital, College of Medicine, Seoul, South Korea.
authors.forename: Yu-Jin
authors.initials: YJ
authors.lastname: Koo
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University, College of Medicine, Seoul, South Korea. Electronic address: oncolim@korea.com.
authors.forename: Kyung-Taek
authors.initials: KT
authors.lastname: Lim
mesh_terms: D000328:Adult; D000740:Anemia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D000077216:Carcinoma, Ovarian Epithelial; D061807:Catheter Obstruction; D002408:Catheters, Indwelling / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000209:etiology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D065426:Cytoreduction Surgical Procedures; D003967:Diarrhea / Q000139:chemically induced; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D045823:Ileus / Q000139:chemically induced; D007263:Infusions, Parenteral; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014839:Vomiting / Q000139:chemically induced; D028761:Withholding Treatment
chemical_list: D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin
keywords: intraperitoneal chemotherapy; ovarian cancer; toxicity of chemotherapy