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Abdominal chemo boosts survival in ovarian cancer patients

A 50-year-old method for delivering chemotherapy directly into the abdomen is making a comeback as investigators have found that it increases survival - by more than a year - in some women with advanced ovarian cancer. Results from a seven-year study of more than 400 patients nationwide are published in the January 5 issue of the New England Journal of Medicine.

Investigators randomly grouped women with newly diagnosed stage III ovarian cancer into two categories: those who would get all chemotherapy intravenously or those who would get chemotherapy both intravenously and through a spaghetti-like tube called a catheter that was inserted directly into the abdomen.

"The catheter allows us to bathe the entire abdominal area with a high concentration of chemotherapy for a long period of time, which appears to be better at destroying lingering cancer cells," says Deborah Armstrong, M.D., associate professor at the Johns Hopkins Kimmel Cancer Center and principal investigator for the study, which was conducted by the Gynecologic Oncology Group. While the abdominal area is the main site for ovarian cancer spread, Armstrong says that the intravenous round of chemotherapy is needed to catch cancer cells that may have spread outside the abdomen.

Overall survival for 205 patients receiving abdominal (or intraperitoneal) chemotherapy in the study was an average of 65.6 months, a 25 percent improvement over the intravenous-only group (49.7 months) of 210 patients. Similarly, relapse-free survival for those receiving intraperitoneal chemo was 23.8 months compared with 18.3 months for the intravenous-alone group, a 20 percent improvement.

"This is a significant improvement in survival for women with this disease, which is most often diagnosed at an advanced stage," notes Armstrong.

Side effects, such as suppressed blood counts and neurological problems, were significantly worse for the group receiving intraperitoneal (IP) chemotherapy. T
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Contact: Vanessa Wasta
wastava@jhmi.edu
410-955-1287
Johns Hopkins Medical Institutions
4-Jan-2006


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