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Intraperitoneal chemotherapy for ovarian cancer. Ovarian cancer tends to spread within the peritoneal cavity rather than metastasizing via blood or the lymphatic system. Now, according to a study published in the January 5 issue of the New England Journal of Medicine, women with stage III ovarian cancer treated with intraperitoneally administered cisplatin and paclitaxel have better outcomes than those treated intravenously.


Four hundred fifteen women were randomized to either a control (IV chemotherapy) group or an experimental (peritoneal chemotherapy) group. Both underwent surgical "debulking" and six courses of chemotherapy.


Because of problems related to the intraperitoneal catheters and toxicity, only 42% of patients in the experimental group were able to complete the protocol. However, progression-free survival was significantly longer in that group (almost two years versus a year and a half), as was overall survival (nearly five and a half years versus four).


Links to nursing and medical guidelines on intraperitoneal chemotherapy administration and patient education are available through the Web site of the Gynecologic Oncology Group, a part of the National Cancer Institute:


Benzocaine sprays banned from the Veterans Health Administration system. The U.S. Food and Drug Administration (FDA) issued a public health advisory on February 10 about the potential development of methemoglobinemia associated with overuse or improper use of topical oral sprays containing benzocaine. The advisory appeared after the Veterans Health Administration declared it would halt all use of such products, saying there are effective topical anesthetics that are less likely to cause methemoglobinemia. Warnings have been issued previously-by the FDA in 2003 and by the Institute for Safe Medication Practices in 2002. In the advisory, the FDA says it considers methemoglobinemia to be an uncommon adverse effect.


First national survey of critical care units. The American Association of Critical-Care Nurses has published the results of a survey designed to describe the scope of practice, staffing, and operations issues of critical care units in the United States. The report was published in the January issue of the American Journal of Critical Care and is available free online at