Delivering chemotherapy directly into the abdominal cavity can extend the lives of some advanced ovarian cancer patients by a significant amount, according to a study published in this week's New England Journal of Medicine. The results provide new hope for patients, since regular intravenous chemotherapy often fails to keep ovarian cancer at bay.

The study found that women who received abdominal chemotherapy—in which drugs are delivered through a catheter into the areas that may be hiding cancer—as well as regular intravenous chemo survived an average of nearly 5½ years , compared with just over four years for those who received IV chemo alone. Abdominal chemo can be delivered in much higher doses than regular chemo.

The approach isn't new; indeed, two other major studies previously found that abdominal chemo extends survival. But the method hasn't become standard treatment for a variety of reasons, including concerns about harsh side effects and uncertainty about the correct mix and concentration of drugs. The women in this study experienced worse side effects initially, but quality of life returned to normal after a year. It was a matter of combining the abdominal method with the right mix of drugs, says Deborah Armstrong, principal investigator for the study and an oncologist at the Johns Hopkins Kimmel Cancer Center. The study involved 415 patients at dozens of cancer centers and hospitals.

The regimen isn't for every woman with ovarian cancer. The patients in this study all had Stage III disease and after surgery had no tumors bigger than one centimeter in diameter. That's important, because the drug must be able to penetrate the tumors; the technique hasn't been studied in women with more advanced disease. The IV chemo is necessary to eliminate any cancer cells that aren't reached by the abdominal therapy.

Given the latest research, there is now no reason for oncologists not to offer this option to patients who fit the criteria, says Maurie Markman, vice president for clinical research at the University of Texas M.D. Anderson Cancer Center and author of a previous study on abdominal chemo. "There isn't a word you can use that will overstate the impact of this," he says.