Miejsce chemioterapii dootrzewnowej w pierwszorzutowym leczeniu raka jajnika

• Authors: Radosław Mądry , Janina Markowska , Jolanta Lubin

Title variants

EN

Intraperitoneal chemotherapy as first-line treatment of ovarian cancer

• Languages of publication: EN PL

Abstracts

EN

Intraperitoneal chemotherapy (IP) in the treatment of ovarian cancer became lately an attractive alternative to standard intravenous chemotherapy. This was a consequence of publication in 2006 of phase III trials indicating that this approach provided clinical benefit as compared with traditional approach in terms of progression-free survival (24 vs. 18 months) and overall survival (66 vs. 50 months, respectively). The present paper reviews theoretical basis of IP, recapitulates milestones of research leading to introduction of IP as first-line therapeutic option and discusses IP-associated adverse effects. Discussion includes impact of IP on patients’ quality of life and effectiveness of other protocols, e.g. those replacing cisplatin by carboplatin. The authors highlight several problems associated with a more widespread use of IP in the treatment of ovarian cancer and indicate novel trends in research, heralded by publications concerning once-weekly administration of paclitaxel. At present, IP as first-line therapy is indicated in FIGO stages II-IV, with residual disease of less than 1 cm after primary cytoreduction. Side effects associated with this therapeutic modality may be classified as drug-dependent and catheter-dependent. The may be minimized by proper selection of patients and port-care. At present, several clinical trials are underway, testing other dosage regimens and chemotherapy protocols. Concomitantly, clinical trials being performed, enable inclusion of patients after IP chemotherapy.

PL

Chemioterapia dootrzewnowa (intraperitoneal chemotherapy, IP) w raku jajnika stała się w chwili obecnej alternatywną strategią leczenia do standardowej dożylnej chemioterapii. Jest to efektem opublikowanych w 2006 roku wyników badania III fazy, które wykazały, że IP w porównaniu ze standardową chemioterapią wydłuża czas do wystąpienia progresji (odpowiednio 24 vs 18 miesięcy) oraz całkowity czas przeżycia (odpowiednio 66 vs 50 miesięcy). W pracy autorzy przedstawiają podstawy teoretyczne chemioterapii dootrzewnowej, historię badań, które doprowadziły do wprowadzenia IP jako alternatywy w leczeniu pierwszorzutowym, oraz objawy uboczne charakterystyczne dla chemioterapii dootrzewnowej. Omówiono również wpływ IP na jakość życia oraz stosowanie innych schematów, w tym zastąpienie cisplatyny karboplatyną. W dyskusji autorzy wskazują na problemy związane z szerokim wprowadzeniem IP do leczenia raka jajnika oraz na nowe kierunki badań związanych z publikacjami dotyczącymi podawania paklitakselu co 7 dni. W chwili obecnej zaleceniem do stosowania IP jako leczenia I rzutu powinna być choroba od II do IV stopnia według FIGO z resztkami nieprzekraczającymi 1 cm po pierwotnej cytoredukcji. Objawy uboczne związane są z rodzajem podawanego dootrzewnowo cytostatyku oraz cewnikiem i można je zminimalizować poprzez właściwy dobór pacjentów i dbałość o port. W chwili obecnej trwa kilka badań klinicznych, które testują inne dawki i schematy podawania cytostatyków. Równocześnie większość prowadzonych obecnie badań klinicznych umożliwia włączanie pacjentów po chemioterapii IP.

Keywords

EN

IP-associated adverse effects; chemioterapia dootrzewnowa; cisplatins; cisplatyna; first-line therapy; intraperitoneal chemotherapy; leczenie pierwszorzutowe; ovarian cancer; powikłania po IP; rak jajnika

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Current Gynecologic Oncology
• Year: 2010
• Volume: 8
• Issue: 2
• Pages: 90-103

Contributors

author

Radosław Mądry

• Klinika Onkologii, Uniwersytet Medyczny, ul. Łąkowa 1/2, 61-878 Poznań, tel. [phone], tel. kom.: 501 149 213, faks: 61 851 04 90. Kierownik Kliniki: prof. dr hab. n. med. Janiana Markowska

author

Janina Markowska

• Klinika Onkologii Uniwersytetu Medycznego w Poznaniu. Kierownik Kliniki: prof. dr hab. n. med. Janiana Markowska

author

Jolanta Lubin

• Klinika Onkologii Uniwersytetu Medycznego w Poznaniu. Kierownik Kliniki: prof. dr hab. n. med. Janiana Markowska

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• Document Type: article