Intraperitoneal Chemotherapy for Ovarian Cancer
Not all patients are candidates for IP therapy. Excluded are patients with bulky or residual disease greater than 1 cm. In addition, several conditions may prevent continuation of IP chemotherapy, such as catheter complications (e.g., improper placement, leakage, inability to infuse), comorbid diseases, and intolerable side effects including severe nausea, vomiting, electrolyte imbalance, or persistent abdominal pain (Markman & Walker, 2006). Patients receiving IP therapy require more frequent nursing assessment because of the potential for these challenging side effects (Potter & Held-Warmkessel, 2008). In addition, physician offices and infusion centers inexperienced with IP administration may shy away from recommending this route of therapy.
In the GOG 172 protocol, the IP regimen demonstrated a distinctly different side effect profile from IV chemotherapy. More grade 3 and 4 events took place in the IP regimen, specifically leukopenia (76% versus 64%), gastrointestinal (46% versus 24%), metabolic (27% versus 7%), neuropathy (19% versus 9%), and fatigue (18% versus 4%) (Armstrong et al., 2006). In addition, quality of life was evaluated using the Functional Assessment of Cancer–Ovarian questionnaire; those who received the IP regimen reported a worse quality of life. However, at one-year follow-up, the quality-of-life results for both groups remained similar (Armstrong et al., 2006; Wenzel, Huang, Armstrong, Walker, & Cella, 2007).
Intraperitoneal Therapy
Not all patients are candidates for IP therapy. Excluded are patients with bulky or residual disease greater than 1 cm. In addition, several conditions may prevent continuation of IP chemotherapy, such as catheter complications (e.g., improper placement, leakage, inability to infuse), comorbid diseases, and intolerable side effects including severe nausea, vomiting, electrolyte imbalance, or persistent abdominal pain (Markman & Walker, 2006). Patients receiving IP therapy require more frequent nursing assessment because of the potential for these challenging side effects (Potter & Held-Warmkessel, 2008). In addition, physician offices and infusion centers inexperienced with IP administration may shy away from recommending this route of therapy.
In the GOG 172 protocol, the IP regimen demonstrated a distinctly different side effect profile from IV chemotherapy. More grade 3 and 4 events took place in the IP regimen, specifically leukopenia (76% versus 64%), gastrointestinal (46% versus 24%), metabolic (27% versus 7%), neuropathy (19% versus 9%), and fatigue (18% versus 4%) (Armstrong et al., 2006). In addition, quality of life was evaluated using the Functional Assessment of Cancer–Ovarian questionnaire; those who received the IP regimen reported a worse quality of life. However, at one-year follow-up, the quality-of-life results for both groups remained similar (Armstrong et al., 2006; Wenzel, Huang, Armstrong, Walker, & Cella, 2007).
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