Intraperitoneal chemotherapy in the management of ovarian cancer

During the past decade, intraperitoneal therapy of ovarian cancer has evolved from a pharmacologic model into an established treatment technique for women with this malignancy. Approximately 40% of patients with small‐volume residual ovarian cancer (microscopic disease or macroscopic tumor, ≤ 0.5 cm in maximum tumor diameter), after an objective response to initial organoplatinum‐based systemic chemotherapy, may have a surgically documented complete response to platinum‐based intraperitoneal chemotherapy. Patients who have not responded to systemic platinum administration rarely will respond to the drug given intraperitoneally, despite the presence of only small‐volume residual disease when this regional treatment strategy is used. Other agents with antineoplastic activity after intraperitoneal administration in women with ovarian cancer include mitoxantrone, taxol, alpha‐interferon and gamma‐interferon, and interleukin‐2. Although intraperitoneal therapy currently is being examined as a component of the initial chemotherapeutic program for patients with ovarian cancer, a precise role for regional drug delivery in this clinical setting remains to be defined.