Chimiothérapie intrapéritonéale et cancer de l'ovaire: l'Un des nouveaux standards en première ligne?

The aim of intraperitoneal chemotherapy is to increase chemotherapy activity in exposing tumor to important cytotoxic drug concentration one to several logs greater with regional treatment. Intraperitoneal chemotherapy (IP) is given by infusion of the chemotherapeutic agent directly into the peritoneal cavity. This may increase the anticancer effect with fewer systemic adverse effects to comparison to intravenous therapy. In ovarian cancer, intraperitoneal chemotherapy has been used in second line treatment, in consolidation, and in first-line combination. The most recent trial conducted by the Gynecologic Oncology Group (GOG) study, a phase III randomised trial and reported by Armstrong et al. published in the New England Journal of Medecine in 2006, demonstrated that IP chemotherapy improves survival in patients with surgically treated ovarian cancer when added to intravenous therapy, compared with IV therapy alone. This study could change the standard treatment in advanced ovarian cancer. Despite increased toxic effects and the more complicated logistics of the drug administration, the data from GOG trial establish IP chemotherapy as an important advance in the first-line treatment of patients with optimally debulked stage III disease.