Intraperitoneal chemotherapy in the management of ovarian cancer

Initial phase I trials of intraperitoneal chemotherapy in ovarian cancer patients demonstrated that a pharmacologic advantage was achieved with the direct instillation of drugs into the peritoneal cavity. Recent trials have reported that approximately 30% of patients who have small-volume residual disease following induction chemotherapy will achieve a complete remission with intraperitoneal cisplatin. The demonstrated effectiveness and acceptable toxicity makes cisplatin the current drug of choice in the intraperitoneal therapy of ovarian cancer patients. Additional clinical studies are required to determine the role of combinations intraperitoneally, the necessity of intravenous sodium thiosulfate for use with intraperitoneal cisplatin, the activity of other agents, the optimum techniques to deliver intraperitoneal drugs, and the appropriate clinical situations where intraperitoneal therapy should be used in the overall management of ovarian cancer.