Pumping Chemotherapy Drugs Into Abdomen Extends Lives of Ovarian Cancer Patients, Study Finds

A rarely used method of pumping chemotherapy drugs into a patient's abdomen extends the lives of ovarian cancer patients, despite severe side effects, such as infection, stomach pain and numbness in the extremities, according to a study published on Thursday in the New England Journal of Medicine, the Boston Globe reports (Kowalczyk, Boston Globe, 1/5).

Deborah Armstrong of Johns Hopkins Kimmel Cancer Center and colleagues conducted the study at several hospitals across the U.S., looking at chemotherapy regimens for 415 women, all of whom had ovarian tumors removed.

Half of the women received standard intravenous chemotherapy treatment and the other half received drugs through a combination of intravenous methods and intraperitoneal therapy, meaning the chemotherapy drugs were pumped directly into the abdomen. Researchers found that women receiving the combination therapy lived an average of five and a half years compared with an average of four years and two months for women who received only the intravenous treatment (AP/Washington Post, 1/5).

However, more than half of women receiving the combination therapy ended the regimen before the recommended 18 weeks because of severe side effects. According to the study, patients in that category had a "worse quality of life" compared with women receiving only the intravenous treatment.

Researchers noted both groups had the same quality of life one year after treatment ended (Bor, Baltimore Sun, 1/5).

Doctors say the findings are encouraging because women who received the combination therapy, even those who did not finish the recommended course of treatment, fared better than women with only the intravenous treatment (Grady, New York Times, 1/5).

The National Cancer Institute, in its first endorsement of any cancer treatment since 1999, in a statement on Wednesday urged doctors to recommend the combination therapy to ovarian cancer patients (AP/Washington Post, 1/5). The institute also posted information about combination therapy, as well as a list of medical centers that provide the treatment, on a separate Web site.

Edward Trimble of NCI's Division of Cancer Treatment and Diagnosis said, "We want to use the bully pulpit of [NCI] to say that patients and doctors need to be aware of this information" (New York Times, 1/5).

In an accompanying NEJM editorial, Stephen Cannistra of Beth Israel Deaconess Medical Center and Harvard Medical School writes that the findings are "one of the largest benefits ever observed for a new therapy" in gynecologic cancer (Rubin, USA Today, 1/5).

Cannistra writes that the treatment should be "individualized," adding, "Given the survival advantage of the treatment, many patients will be willing to undergo intraperitoneal therapy, even after being informed of its short-term effects on the quality of life, and others will not be willing to do so." Cannistra concludes by calling the combination therapy "an important advance in the first-line treatment of patients" with late-stage ovarian cancer (Cannistra, New England Journal of Medicine, 1/5).

An abstract of the study is available online.

The editorial is available online.