Feasibility and Safety of Repeated Intraperitoneal Platinum and Pegylated Liposomal Doxorubicin for First Recurrent...

Background/Objectives: Pegylated liposomal doxorubicin (PLD) has been used in hyperthermic intraperitoneal chemotherapy and early postoperative intraperitoneal chemotherapy. However, the safety and feasibility of repeated intraperitoneal administration of PLD have not been previously reported. This retrospective comparative study aimed to evaluate the feasibility, safety, and preliminary clinical outcomes of repeated intraperitoneal platinum combined with PLD in women with first recurrent ovarian cancer, compared with conventional intravenous platinum/PLD. Methods: We retrospectively reviewed all consecutive women with first recurrent ovarian cancer who received either repeated intraperitoneal platinum combined with intraperitoneal and intravenous PLD (IP group, n = 13) or intravenous platinum combined with intravenous PLD (IV group, n = 17) at a tertiary referral center. Results: Median progression-free survival was 13.7 months (95% confidence interval [CI], 10.2 months to not reached) in the IP group and 11.9 months (95% CI, 7.0-14.2 months) in the IV group (p = 0.179). Median overall survival was not reached in the IP group and 30.5 months in the IV group (p = 0.510). Toxicity profiles were comparable between groups. No cases of peritoneal sclerosis or adhesion-related bowel obstruction were observed following repeated intraperitoneal PLD. Conclusions: Repeated intraperitoneal administration of platinum combined with PLD appears to be a safe and feasible treatment strategy for recurrent epithelial ovarian cancer. However, whether this intraperitoneal approach provides additional clinical benefit over conventional intravenous platinum/PLD remains uncertain and warrants further investigation in large-scale studies.