Background We aimed to compare the clinical outcomes between intraperitoneal chemotherapy and dose-dense chemotherapy for the frontline treatment of advanced ovarian, fallopian tube and primary peritoneal cancer in women not receiving bevacizumab.
Methods All consecutive women with stage II~IV cancer treated with either frontline intraperitoneal or dose-dense platinum/paclitaxel chemotherapy and not receiving bevacizumab between March 2006 and June 2019 were reviewed.
Results A total of 50 women (intraperitoneal group, n=22; dose-dense group, n=28) were reviewed. Median progression-free survival (32.6 months versus 14.2 months; adjusted hazard ratio=0.38; 95% CI=0.16 to 0.90, p=0.03, figure 1a) and overall survival (not reached versus 30.7 months; adjusted hazard ratio=0.23, 95% CI=0.07 to 0.79, p=0.02, figure 1b) were significantly higher in the intraperitoneal group than in the dose-dense group. A multivariable Cox proportional-hazards model also indicated that the number of frontline chemotherapy cycles (adjusted hazard ratio=0.66, 95% CI 0.47 to 0.94, p=0.02, table 1) was a predictor of better overall survival. Nausea/vomiting and nephrotoxicity occurred more frequently in the intraperitoneal group (p=0.02 and <0.0001, respectively).
Conclusion Intraperitoneal chemotherapy seems to be superior in progression free survival and overall survival to dose-dense chemotherapy in the frontline treatment of women with advanced ovarian, fallopian tube or primary peritoneal cancer and not receiving bevacizumab.
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