Analysis of morbidity and mortality in 60 patients with peritoneal carcinomatosis treated by cytoreductive surgery and heated intraoperative intraperitoneal chemotherapy

Jacquet, Pierre; Stephens, Dana; Averbach, Andrew; Chang, B S David; Ettinghausen, Steven E.; Dalton, Rory R.; Steves, Mark A.; Sugarbaker, Paul H.

doi:10.1002/(sici)1097-0142(19960615)77:12<2622::aid-cncr28>3.0.co;2-t

Cited by 218 publications

(79 citation statements)

References 28 publications

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“…19 One treatment approach is cytoreductive surgery combined with the intraperitoneal administration of cytotoxic agents. 20 This may diminish any residual tumor after macroscopic excision and may overcome the pharmacokinetic limits of systemic chemotherapy. Intraperitoneal chemotherapy gives high response rates within the abdomen because the ''peritoneal plasma barrier'' provides doseintensive therapy 21 since high-molecular-weight substances are confined to the abdominal cavity for long time periods.…”

Section: Discussionmentioning

confidence: 99%

Doxorubicin and mitoxantrone drug eluting beads for the treatment of experimental peritoneal carcinomatosis in colorectal cancer

Keese

Gasimova

Schwenke

et al. 2009

Intl Journal of Cancer

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We investigated the therapeutic efficiency of sulfonate-modified polyvinyl alcohol beads loaded with doxorubicin, irinotecan or mitoxantrone in vitro and in vivo in a model of experimental peritoneal carcinomatosis (PC). In vitro, cell proliferation was efficiently impaired by doxorubicin drug eluting bead (DEB) treatment while mitoxantrone DEBs were less effective than. Irinotecan showed little effect for both DEBs and free drug. Apoptosis was not different between free mitoxantrone and the DEB form while more apoptosis induction was observed in cells incubated with free doxorubicin and irinotecan. Experimental PC was produced in mice. The therapeutic efficiency of either mitoxantrone and doxorubicin DEB or free drugs were compared. Mice were treated either once on day 12 or by 3 repetitive applications on days 7, 10 and 12. Mice treated by DEBs showed less weight loss and mortality. Therapeutic effect was determined by measuring tumor volume and tumor load on the day 15 after tumor inoculation. For the single application on the day 12, an advantage could be observed for the free drugs. After 3 repeated injections of both free and mitoxantrone DEB no difference in tumor load or tumor volume could be observed. Least tumor load and tumor volume was observed in mice that received 3 repeated injections of doxorubicin DEB. No animal survived 3 injections of free doxorubicin. We conclude that bead encapsulation of chemotherapeutic drugs may show the advantage of less toxicity in peritoneal spread of colorectal cancer. '

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Section: Discussionmentioning

confidence: 99%

Doxorubicin and mitoxantrone drug eluting beads for the treatment of experimental peritoneal carcinomatosis in colorectal cancer

Keese

Gasimova

Schwenke

et al. 2009

Intl Journal of Cancer

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“…However, there is a lack of consensus about the optimal target temperature and a finding of increased morbidity and mortality when a cytoreduction procedure has been followed by hyperthermic i.p. chemotherapy (Jacquet et al, 1996) that warrant further studies. To optimise the i.p.…”

Section: Discussionmentioning

confidence: 99%

Improved survival in patients with peritoneal metastases from colorectal cancer: a preliminary study

et al. 2004

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Patients with peritoneal or local metastases from colorectal cancer have a poor prognosis. However, aggressive treatments by debulking surgery and infusional intraperitoneal (i.p.) chemotherapy have been tried and appear to benefit selected patients. We assayed the effects of debulking surgery and i.p. chemotherapy with respect to survival and compared the results with matched control patients treated by intravenous (i.v.) chemotherapy. In all, 18 patients with peritoneal and/or local metastases from colorectal adenocarcinoma underwent debulking surgery followed by 5-fluorouracil (5-FU) 550 mg m À2 day À1 i.p. and leucovorin (LV) 60 mg m À2 day À1 i.v. The chemotherapy was started the day after surgery and was given daily for 6 days and repeated monthly for totally eight courses. The control patients, matched for age, gender, performance status and metastatic site, were randomly selected from controlled clinical chemotherapy trials and treated with i.v. 5-FU þ LV or i.v. methotrexate þ 5-FU þ LV. There was no treatment-related mortality. The median survival among i.p. patients was 32 months compared to 14 months in the control group. In all, 11 patients who underwent macroscopically radical surgery had a longer survival than those who were not radically operated (P ¼ 0.02). These results indicate that patients with peritoneal metastases and/or locally advanced cancers but without distant metastases may benefit from cytoreductive surgery combined with i.p. chemotherapy.

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“…The series with extended peritonectomies combined with IPCH reported a mortality rate of 5% and a morbidity rate of 35%, pointing out the fact that duration of surgery and the number of digestive anastomoses performed were correlated with a higher morbidity rate. 18 As far as indications are concerned, we no longer include patients with unresectable primary tumor as we did at the beginning of our experience. The best indications of IPCH seem to be peritoneal carcinomatosis with small malignant granulations (Stage I and II), and peritoneal carcinomatosis in patients for whom debulking surgery (granulation exeresis or local peritonectomies) appears to be possible.…”

Section: Discussionmentioning

confidence: 99%

“…Animal studies have confirmed the existence of preferential flows inside the abdominal cavity, 12 and here is probably the reason for some bowel complications reported by various authors. 18,21 These preferential flows may induce very high local temperatures as well as very high local drug concentrations.…”

Section: Homogeneous Diffusion Of Heat and Drugs Insidementioning

confidence: 99%

Intraperitoneal chemohyperthermia with mitomycin C for digestive tract cancer patients with peritoneal carcinomatosis

Beaujard

Gléhen²,

Caillot

et al. 2000

Cancer

169

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Analysis of morbidity and mortality in 60 patients with peritoneal carcinomatosis treated by cytoreductive surgery and heated intraoperative intraperitoneal chemotherapy

Abstract: BACKGROUND.Peritoneal carcinoma has been regarded as a uniformly lethal clini-

Cited by 218 publications

References 28 publications

Doxorubicin and mitoxantrone drug eluting beads for the treatment of experimental peritoneal carcinomatosis in colorectal cancer

Doxorubicin and mitoxantrone drug eluting beads for the treatment of experimental peritoneal carcinomatosis in colorectal cancer

Improved survival in patients with peritoneal metastases from colorectal cancer: a preliminary study

Intraperitoneal chemohyperthermia with mitomycin C for digestive tract cancer patients with peritoneal carcinomatosis

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