Second-line chemotherapy for refractory cancer: intraperitoneal chemotherapy

Over the past decade intraperitoneal therapy in the management of ovarian cancer has evolved from a pharmacokinetic concept into a rationale treatment strategy for a specific subset of patients with this disease. Patients with small-volume residual ovarian cancer (microscopic disease only or macroscopic tumor with largest tumor nodule < or = 0.5 cm in maximum diameter) when treatment is initiated are reasonable candidates to be considered for this therapeutic strategy. At least for salvage platinum-based intraperitoneal therapy, a documented prior response to systemic cisplatin or carboplatin helps to define a patient population who would be anticipated to have the greatest opportunity to respond to a regional treatment approach.