Multimodal treatment of peritoneal carcinomatosis and sarcomatosis

Pilati, Pierluigi; Róssi, Carlo; Mocellin, Simone; Foletto, Mirto; Scagnet, B; Pasetto, Lara Maria; Lise, Mario

doi:10.1053/ejso.2000.1021

Cited by 38 publications

(33 citation statements)

References 46 publications

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“…It is generally considered as a systemic disease at clinical presentation, and is resistant to standard treatments. 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.…”

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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“…chemotherapy (3), hyperthermic i.p. intraoperative chemotherapy (4), and intraoperative i.p. photodynamic therapy [PDT (5)].…”

Section: Introductionmentioning

confidence: 99%

Hypoxia and Photofrin Uptake in the Intraperitoneal Carcinomatosis and Sarcomatosis of Photodynamic Therapy Patients

Busch

Hahn

Wileyto³

et al. 2004

Clinical Cancer Research

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Purpose: Response to photodynamic therapy depends on adequate tumor oxygenation as well as sufficient accumulation of photosensitizer in the tumor. The goal of this study was to investigate the presence of hypoxia and retention of the photosensitizer Photofrin in the tumors of patients with intra-abdominal carcinomatosis or sarcomatosis.Experimental Design: Tumor nodules from 10 patients were studied. In nine of these patients, hypoxia was identified in histological sections of biopsied tumor after administration of the hypoxia marker 2-(2-nitroimidazol-1[H]-yl)-N-(2,2,3,3,3-pentafluoropropyl)acetamide (EF5). In separate tumor nodules from 10 patients, Photofrin uptake was measured by fluorescence after tissue solubilization.Results: Hypoxia existed in the tumors of five patients, with three of these patients demonstrating at least one severely hypoxic nodule. Physiological levels of oxygen were present in the tumors of four patients. An association between tumor size and hypoxia was not evident because some tumor nodules as small as ϳ2 mm in diameter were severely hypoxic. However, even these tumor nodules contained vascular networks. Three patients with severely hypoxic tumor nodules exhibited moderate levels of Photofrin uptake of 3.9 ؎ 0.4 to 3.9 ؎ 0.5 ng/mg (mean ؎ SE). The four patients with tumors of physiological oxygenation did not consistently exhibit high tumor concentrations of Photofrin: mean ؎ SE drug uptake among these patients ranged from 0.6 ؎ 0.8 to 5.8 ؎ 0.5 ng/mg.Conclusions: Carcinomatosis or sarcomatosis of the i.p. cavity may exhibit severe tumor hypoxia. Photofrin accumulation in tumors varied by a factor of ϳ10؋ among all patients, and, on average, those with severe hypoxia in at least one nodule did not demonstrate poor Photofrin uptake in separate tumor samples. These data emphasize the need for reconsideration of the generally accepted paradigm of small tumor size, good oxygenation, and good drug delivery because this may vary on an individual tumor basis.

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“…Since this report, numerous basic and clinical studies have been conducted on hyperthermic chemotherapy (3,4). The perfusion system has undergone several improvements.…”

Section: Is Peritoneal Carcinomatosis An Incurable Disease or Controlmentioning

confidence: 99%

Is Peritoneal Carcinomatosis an Incurable Disease or Controllable Locoregional Condition? -- Challenge of Surgeons with Intraperitoneal Hyperthermic Chemotherapy

Sano

2001

Japanese Journal of Clinical Oncology

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Multimodal treatment of peritoneal carcinomatosis and sarcomatosis

Cited by 38 publications

References 46 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

Hypoxia and Photofrin Uptake in the Intraperitoneal Carcinomatosis and Sarcomatosis of Photodynamic Therapy Patients

Is Peritoneal Carcinomatosis an Incurable Disease or Controllable Locoregional Condition? -- Challenge of Surgeons with Intraperitoneal Hyperthermic Chemotherapy

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