Study of the Isotopic Distribution of Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Ovarian Origin
Status:
Withdrawn
Trial end date:
2016-09-01
Target enrollment:
Participant gender:
Summary
The treatment of advanced ovarian cancer is based on the combination of chemotherapy based on
platinum salt and surgery whose quality is the major prognostic factor.
A meta-analysis of retrospective series had shown that for every 10% increase in the complete
cytoreduction rates were increased by 5.5% overall survival time (Markman et al, 2001).
Currently, it is recognized that the best chance of survival conferred to patients whose
initial surgical residue is zero (Harter et al, 2009).
However, even if macroscopically complete surgery and whatever the type of systemic
chemotherapy, peritoneal recurrence remains high for more than 75%.
To reducing it of recurrence, a therapeutic approach is to administer chemotherapy
intraperitoneally.
The intraperitoneal chemotherapy consists to administer the drug directly into the peritoneal
cavity.
Alberts et al, 1996 and Armstrong et al, 2006 compared the efficacy in terms of survival of
an intraperitoneal chemotherapy according to this method with a conventional systemic
chemotherapy. Alberts reported a significant improvement in the median overall survival.
Armstrong shows in addition a decreased risk of recurrence.
It must be remembered that:
- The establishment of an intra-abdominal catheter does not always ensure complete flow of
drugs into the peritoneal cavity (major postoperative adhesions).
- There may be problems of catheters becoming blocked and requiring local treatment; these
problems can cause abdominal pain whose care is difficult. Thus almost half of patients
fail to get all six courses of intraperitoneal chemotherapy.
Thus, the investigators propose to estimate the flow of intraperitoneal chemotherapy with IP
peritoneal scintigraphy, using a radiotracer (nanocis®). The investigators hypothesize that
the movement of colloids in peritoneal cavity is similar to the circulation of chemotherapy
within the peritoneal cavity (From Forni et al, 1993, Varia et al, 2003, Young et al, 2003,
Dawson et al, 2011). The accumulation of radiotracer will be more correlated with abdominal
pain sites described by the patient as well as peritoneal recurrence sites found during
monitoring.