Ovarian cancer intraperitoneal chemotherapy

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Not every solid lesion in a postoperative patient means ovarian cancer recurrence. The combination of CA-125 and a baseline imaging study usually aids in the differential diagnosis. Postoperative hematomas, adhesions between bowel loops, or locahzed trapped fluid may mimic recurrent disease. Benign forms of diffuse peritoneal thickening such as a result of postoperative inflammatory complications or bacterial peritonitis cannot be differentiated from peritonitis carcinomatosa. Furthermore, chemical peritonitis following intraperitoneal chemotherapy also results in diffuse peritoneal thickening [32]. 

In a phase I study of intraperitoneal paclitaxel in patients with advanced ovarian cancer, severe abdominal pain was the dose-limiting toxicity at doses over 175 mg/rr [57 ]. Significant gastrointestinal adverse reactions have been noted in other trials of intrap eritoneal paclitaxel chemotherapy, and this has limited its usefulness as a means of administering chemotherapy via this route [58, 597]. 

Robinson WR, Coberly C, Beyer J, Lewis A, Ballard C. Office-based intraperitoneal chemotherapy for ovarian cancer. J Oncol Pract 2008 4(5) 225-8. 

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