PRESENTED BYDR.AYUSH GARG

PG JR IRADIOTHERAPY

INTRAPERITONEAL CHEMOTHRAPY

Theory of IP approach• We use intraperitoneal chemotherapy to treat ovarian cancer, which often

spreads within the abdominal cavity.• The rationale for intraperitoneal chemotherapy - the peritoneum receives

sustained exposure to high concentrations of antitumor agents while normal tissues are relatively spared • IP chemotherapy not effective in bulky disease; should be targeted at

women with no residual or minimal residual disease• Chemotherapeutic agents with higher molecular weight had longer half-lives• Platinums/ taxanes have 10-20 times greater concentration IP than when

given IV

Clinical settings evaluated• Intraoperative at time of primary or secondary surgery

• Post-operative in advanced diseaseOptimally & suboptimally debulked

• Adjuvant for early-stage disease

• After neo-adjuvant chemo + surgery

Catheter Implantation

IP-Catheter

The drugs are injected into the abdominal cavity through a catheter (thin tube).

• The tube can be placed during the staging/debulking surgery, but sometimes it is placed later.

• If it is done later, it can be placed by a surgeon using laparoscopy, or by an interventional radiologist under X-Ray guidance.

• The catheter is usually connected to a port, a half dollar-sized disk topped with a pliable diaphragm.

• The port is placed under the skin.• A needle can be placed through the skin

and into the port to give chemo and other drugs.

Giving chemo this way gives the most concentrated dose of the drugs to the cancer cells in the abdominal cavity. This chemo also gets absorbed into the bloodstream and so can reach cancer cells outside the abdominal cavity.

Toxicity with IP chemotherapy

• Presence of an IP catheterInfection, fever

• IP administration of chemotherapyAbdominal pain, nausea, vomiting

• ChemotherapyGreater hematologic, metabolic, and neurologic toxicity

Conclusion- IP chemotherapy has a clinical advantage in the Ovarian Cancer - but, toxicity ↑ & quality of life ↓ - It is used in patients with advanced Ovarian Cancer

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