Should We Abandon Intraperitoneal Chemotherapy in the Treatment of Advanced Ovarian Cancer? A Meta-Analysis
Background: Ovarian cancer is the gynaecological malignancy with the highest mortality and diagnosis often occurs in its advanced stages. Standard treatment in these cases is based on complete cytoreductive surgery with adjuvant intravenous chemotherapy. Other types of treatment are being evaluated...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/12/1636 |
| _version_ | 1797380414842601472 |
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| author | Maria Teresa Climent Anna Serra Carolina Balaguer Antoni Llueca |
| author_facet | Maria Teresa Climent Anna Serra Carolina Balaguer Antoni Llueca |
| author_sort | Maria Teresa Climent |
| collection | DOAJ |
| description | Background: Ovarian cancer is the gynaecological malignancy with the highest mortality and diagnosis often occurs in its advanced stages. Standard treatment in these cases is based on complete cytoreductive surgery with adjuvant intravenous chemotherapy. Other types of treatment are being evaluated to improve the prognosis of these patients, including intraperitoneal chemotherapy and antiangiogenic therapy. These may improve survival or time to relapse in addition to intravenous chemotherapy. Objective: The aim of this meta-analysis is to determine whether treatment with intravenous chemotherapy remains the gold standard, or whether the addition of intraperitoneal chemotherapy has a benefit in overall survival (OS) and disease-free interval (DFS). Materials and methods: A literature search was carried out in Pubmed and Cochrane, selecting clinical studies and systematic reviews published in the last 10 years. Statistical analysis was performed using the hazard ratio measure in the RevMan tool. Results: Intraperitoneal chemotherapy shows a benefit in OS and DFS compared with standard intravenous chemotherapy. The significant differences in OS (HR: 0.81 CI 95% 0.74–0.88) and in DFS (HR: 0.81 CI 95% 0.75–0.87) are statistically significant (<i>p</i> < 0.00001). There were no clinical differences in toxicity and side-effects. Conclusion: Intraperitoneal chemotherapy is an option that improves OS and DFS without significant toxicity regarding the use of intravenous chemotherapy alone. However, prospective studies are needed to determine the optimal dose and treatment regimen that will maintain the benefits while minimising side effects and toxicity and the profile of patients who will benefit most from this treatment. |
| first_indexed | 2024-03-08T20:36:55Z |
| format | Article |
| id | doaj.art-7ad42bfbcffc4bc6a85870ca91276497 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-08T20:36:55Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-7ad42bfbcffc4bc6a85870ca912764972023-12-22T14:19:47ZengMDPI AGJournal of Personalized Medicine2075-44262023-11-011312163610.3390/jpm13121636Should We Abandon Intraperitoneal Chemotherapy in the Treatment of Advanced Ovarian Cancer? A Meta-AnalysisMaria Teresa Climent0Anna Serra1Carolina Balaguer2Antoni Llueca3Multidisciplinary Unit of Abdominopelvic Oncological Surgery (MUAPOS), Department of Obstetrics and Gynaecology, Hospital General Universitario de Castellón, 12004 Castellón, SpainMultidisciplinary Unit of Abdominopelvic Oncological Surgery (MUAPOS), Department of Obstetrics and Gynaecology, Hospital General Universitario de Castellón, 12004 Castellón, SpainDepartment of Medicine, University Jaume I (UJI), 12004 Castellón, SpainMultidisciplinary Unit of Abdominopelvic Oncological Surgery (MUAPOS), Department of Obstetrics and Gynaecology, Hospital General Universitario de Castellón, 12004 Castellón, SpainBackground: Ovarian cancer is the gynaecological malignancy with the highest mortality and diagnosis often occurs in its advanced stages. Standard treatment in these cases is based on complete cytoreductive surgery with adjuvant intravenous chemotherapy. Other types of treatment are being evaluated to improve the prognosis of these patients, including intraperitoneal chemotherapy and antiangiogenic therapy. These may improve survival or time to relapse in addition to intravenous chemotherapy. Objective: The aim of this meta-analysis is to determine whether treatment with intravenous chemotherapy remains the gold standard, or whether the addition of intraperitoneal chemotherapy has a benefit in overall survival (OS) and disease-free interval (DFS). Materials and methods: A literature search was carried out in Pubmed and Cochrane, selecting clinical studies and systematic reviews published in the last 10 years. Statistical analysis was performed using the hazard ratio measure in the RevMan tool. Results: Intraperitoneal chemotherapy shows a benefit in OS and DFS compared with standard intravenous chemotherapy. The significant differences in OS (HR: 0.81 CI 95% 0.74–0.88) and in DFS (HR: 0.81 CI 95% 0.75–0.87) are statistically significant (<i>p</i> < 0.00001). There were no clinical differences in toxicity and side-effects. Conclusion: Intraperitoneal chemotherapy is an option that improves OS and DFS without significant toxicity regarding the use of intravenous chemotherapy alone. However, prospective studies are needed to determine the optimal dose and treatment regimen that will maintain the benefits while minimising side effects and toxicity and the profile of patients who will benefit most from this treatment.https://www.mdpi.com/2075-4426/13/12/1636advanced ovarian cancerintraperitoneal chemotherapyoverall survivaldisease-free survivalprimary cytorreductive surgery |
| spellingShingle | Maria Teresa Climent Anna Serra Carolina Balaguer Antoni Llueca Should We Abandon Intraperitoneal Chemotherapy in the Treatment of Advanced Ovarian Cancer? A Meta-Analysis Journal of Personalized Medicine advanced ovarian cancer intraperitoneal chemotherapy overall survival disease-free survival primary cytorreductive surgery |
| title | Should We Abandon Intraperitoneal Chemotherapy in the Treatment of Advanced Ovarian Cancer? A Meta-Analysis |
| title_full | Should We Abandon Intraperitoneal Chemotherapy in the Treatment of Advanced Ovarian Cancer? A Meta-Analysis |
| title_fullStr | Should We Abandon Intraperitoneal Chemotherapy in the Treatment of Advanced Ovarian Cancer? A Meta-Analysis |
| title_full_unstemmed | Should We Abandon Intraperitoneal Chemotherapy in the Treatment of Advanced Ovarian Cancer? A Meta-Analysis |
| title_short | Should We Abandon Intraperitoneal Chemotherapy in the Treatment of Advanced Ovarian Cancer? A Meta-Analysis |
| title_sort | should we abandon intraperitoneal chemotherapy in the treatment of advanced ovarian cancer a meta analysis |
| topic | advanced ovarian cancer intraperitoneal chemotherapy overall survival disease-free survival primary cytorreductive surgery |
| url | https://www.mdpi.com/2075-4426/13/12/1636 |
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