RESUMEN
OBJECTIVE: To probe into the advantages and disadvantages of intravenous chemotherapy and intraperitoneal chemotherapy for advanced epithelial ovarian cancer. METHODS: All of the 226 patients with advanced epithelial ovarian cancer were treated by maximum cytoreductive surgery or non-effective cytoreductive surgery and received 6 - 8 courses of postoperative regular chemotherapy (chemotherapy regimens, TP: taxol and cis-platinum or carboplatinum; PC: cis-platinum and cyclophosphamide; PAC: cis-platinum and adriamycin and cyclophosphamide) during Jan 1998 - Jan 2006. We systematically compared the characteristics of patients in intraperitoneal chemotherapy (IPC) group and intravenous chemotherapy (IVC) group. We measured the incidence rate of the response, side-effects, the recurrence time of intraperitoneal tumor and survival time of the two groups respectively. RESULTS: For the first phase after operation (three courses of treatment), the response rate of two groups were 75.8% and 52.8% respectively. For the response rate of IPC was higher than that of IVC (P < 0.01). The second phase after operation (all courses finished), the response rate of two groups were 93.9% and 87.7%, respectively (P > 0.05). After maximum cytoreductive surgery, the recurrence rate of IPC and IVC were 47.0% and 59.4%, respectively (P > 0.05). After non-effective cytoreductive surgery of IPC and IVC groups, the recurrence rates were 84.8% and 86.2%, respectively (P > 0.05). The recurrence time of intraperitoneal tumor of IPC and IVC groups were 24 and 18 months, respectively (P = 0.001). The overall survival time of groups IPC and IVC were 32 and 30 months (P = 0.188). There were some differences in the side-effect between IPC and IVC. The rates of chemotherapeutic phlebitis of IPC and IVC were 34.0% and 10.8% respectively (P < 0.01). The rates of serious gastrointestinal reaction of IPC and IVC were 33.8% and 25.8%, respectively (P = 0.236). There was no significant difference in bone marrow depression, intestinal adhesion and intestinal obstruction. CONCLUSIONS: IPC can extend the disease progression free survival than IVC, without increasing overall survival period. IPC can also reduce the side-effect of chemotherapeutic phlebitis. However, IPC is used limitedly, and can not substitute for IVC. Combination of IPC with IVC may enhance their effectiveness and reduce the side-effects.