Overall survival rate of female patients with advanced ovarian cancer after combined treatment with pressurized intraperitoneal aerosolized chemotherapy
Authors:   Moscow Regional Oncological Dispensary, Balashikha, Russian Federation, Dzasokhov A.S. , Kostin A.A. ,   RUDN University, Moscow, Russian Federation, Astashov V.L. ,   Moscow Regional Oncological Dispensary, Balashikha, Russian Federation, Turiev A.V. ,   Moscow Regional Oncological Dispensary, Balashikha, Russian Federation, Luneva I.Yu. ,   Moscow Regional Oncological Dispensary, Balashikha, Russian Federation
Published: September 2024

Background: ovarian cancer (OC) is considered an aggressive disease diagnosed at late stages, which leads to a decrease in the survival rate of female patients. According to the therapy standards at stage III–IV of this disease, it is recommended to use combined treatment in the form of cytoreductive surgery and adjuvant chemotherapy. At present, the administration method of chemotherapy drugs is being actively discussed, in particular, intravenously or intraperitoneally. Aim: to evaluate the 2-year survival rate of female patients with malignant ovarian neoplasm in peritoneal carcinomatosis after combined treatment with pressurized intraperitoneal aerosolized chemotherapy (PIPAC). Patients and Methods: a prospective randomized controlled trial included 164 female patients with stage IIIB and IIIC OC aged 32 to 75 years, who were randomly divided into two groups. The main group included 79 (48.1%) female patients who, immediately after cytoreductive surgery and anterior abdominal wall wound suturing, underwent a PIPAC course, as well as polychemotherapy (PCT) according to the TС (taxotere + cyclophosphamide) regimen. The control group included 85 (51.9%) female patients who underwent only cytoreductive surgery and PCT according to the above regimen. All patients were monitored for 24 months. Results: the number of fatal complications in the main group after performing three PIPAC courses decreased by almost 2.5 times versus the control group. At the same time, the median overall survival rate after 2 years of follow-up in the main group was 82.4% (95% confidence interval (CI) 0.551–0.939), and in the control group — 75.5% (95% CI 0.531–0.882). To identify statistically significant differences between groups in overall survival rate, the log-rank test, the likelihood-ratio test and the Wald test for the Cox proportional hazards regression model were used. The actual significance levels (p-value) of these tests were 0.07, 0.06, 0.08, respectively. Given the small number of fatal outcomes (only 15 cases), it can be concluded that the control and main groups differ statistically significantly in overall survival rate at the level of 0.06. Conclusion: PIPAC is a modern and effective method for adjuvant chemotherapy in advanced ovarian cancer. Due to the low mortality rate after three PIPAC courses (7.9% less in the main group), it is a safe palliative treatment option for stage IIIB and IIIC OC. KEYWORDS: ovarian cancer, peritoneal carcinomatosis, pressurized intraperitoneal aerosolized chemotherapy, PIPAC, locally advanced cancer, polychemotherapy, overall survival rate. FOR CITATION: Dzasokhov A.S., Kostin A.A., Astashov V.L., Turiev A.V., Luneva I.Yu. Overall survival rate of female patients with advanced ovarian cancer after combined treatment with pressurized intraperitoneal aerosolized chemotherapy. Russian Medical Inquiry. 2024;8(6):332– 337 (in Russ.). DOI: 10.32364/2587-6821-2024-8-6-3.