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Long-Term Survival Analysis of Intraperitoneal versus Intravenous Chemotherapy for Primary Ovarian Cancer and Comparison between Carboplatin- and Cisplatin-based Intraperitoneal Chemotherapy

Authors
 Kyung Jin Eoh  ;  Jung-Yun Lee  ;  Eun Ji Nam  ;  Sunghoon Kim  ;  Young Tae Kim  ;  Sang Wun Kim 
Citation
 Journal of Korean Medical Science, Vol.32(12) : 2021-2028, 2017 
Journal Title
 Journal of Korean Medical Science 
ISSN
 1011-8934 
Issue Date
2017
MeSH
Adult ; Aged ; Agranulocytosis/etiology ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use ; Carboplatin/adverse effects ; Carboplatin/therapeutic use* ; Cisplatin/adverse effects ; Cisplatin/therapeutic use* ; Disease-Free Survival ; Female ; Humans ; Infusions, Intravenous/methods* ; Injections, Intraperitoneal/methods* ; Kaplan-Meier Estimate ; Middle Aged ; Nausea/etiology ; Neoplasm Staging ; Ovarian Neoplasms/drug therapy* ; Ovarian Neoplasms/mortality ; Ovarian Neoplasms/pathology ; Vomiting/etiology
Keywords
Carboplatin ; Intraperitoneal Chemotherapy ; Ovarian Cancer ; Survival
Abstract
In epithelial ovarian cancer (EOC), intraperitoneal (IP) administration of chemotherapy is an effective first-line treatment and may improve outcomes, compared with intravenous (IV) chemotherapy. We used Kaplan-Meier survival analysis to compare long-term survival between propensity score-matched patients with advanced EOC receiving IP (n = 34) vs. IV (n = 68) chemotherapy. Additionally, clinical features associated with carboplatin-based (n = 21) and cisplatin-based (n = 16) IP chemotherapy were analyzed and compared with those associated with IV chemotherapy. The IP and IV chemotherapy groups had a median follow-up duration of 67 (range, 3-131) and 62 (range, 0-126) months, respectively, with no significant difference in progression-free survival (PFS) (P = 0.735) and overall survival (OS) (P = 0.776). A significantly higher proportion of patients in the IV (91.2%) than in the IP (67.6%) chemotherapy group (P = 0.004) received ≥ 6 cycles. However, the frequency of toxic events (anemia, granulocytopenia, nausea/vomiting, abdominal pain, hepatotoxicity, neuromuscular effects) was significantly higher in the IP than in the IV group. Within the IP group, no significant differences were observed in PFS (P = 0.533) and OS (P = 0.210) between the cisplatin-based and carboplatin-based chemotherapy subgroups. The 10-year OS was 28.6% and 49.2% in carboplatin-based and cisplatin-based IP chemotherapy groups, respectively. Toxic events (granulocytopenia, leukopenia, nausea/vomiting, abdominal pain, hepatotoxicity, neuromuscular effects) were significantly more common in the cisplatin-based subgroup. In patients with EOC, cisplatin-based IP chemotherapy may be an acceptable alternative to IV chemotherapy regarding long-term survival, but toxicity must be addressed.
Files in This Item:
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DOI
10.3346/jkms.2017.32.12.2021
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
김상운(Kim, Sang Wun) ORCID logo https://orcid.org/0000-0002-8342-8701
김성훈(Kim, Sung Hoon) ORCID logo https://orcid.org/0000-0002-1645-7473
김영태(Kim, Young Tae) ORCID logo https://orcid.org/0000-0002-7347-1052
남은지(Nam, Eun Ji)
어경진(Eoh, Kyung Jin) ORCID logo https://orcid.org/0000-0002-1684-2267
이정윤(Lee, Jung-Yun) ORCID logo https://orcid.org/0000-0001-7948-1350
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161411
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