Preoperative intraperitoneal oxaliplatin for unresectable peritoneal carcinomatosis of colorectal origin: a pilot study

Abstract

Background: Peritoneal carcinomatosis in colorectal cancer is an advanced stage of the disease where improved survival can be attained whenever the resection associated with hyperthermic intreperitoneal chemotherapy is possible. In unresectable cases, systemic chemotherapy is administered to obtain conversion to resectability but results have not yet been clearly evaluated. Local chemotherapy in this setting has been proven useful in several similar situations. The aim of the present pilot study was to evaluate the feasibility of preoperative intraperitoneal chemotherapy with oxaliplatin in these patients. Methods: Six patients with unresectable peritoneal disease of colorectal origin were included in the study. An intraperitoneal implantable chamber catheter was inserted during the laparotomy that evaluated the extent of the peritoneal disease (peritoneal

Colorectal peritoneal metastases: Optimal management review

“…Some other trials have attempted to rescue high PCI patients for an eventual CRS surgery by using a combination of intraperitoneal plus systemic chemotherapy regimens. The aim of this bidirectional chemotherapy is to reach peritoneal implants not only from the peritoneal cavity but also from subperitoneal blood vessels[107,108].…”

Oxaliplatin use in pressurized intraperitoneal aerosol chemotherapy (PIPAC) is safe and effective: A multicenter study

“…PIPAC was evaluated independently by different groups confirming consistently feasibility, safety, and good tolerance of the procedure(8e10). However, PIPAC-Ox was reluctantly used for fear of toxicity (especially abdominal pain) which was encountered after IP administration of oxaliplatin by means of an intraperitoneal catheter (11) or in form of heated intraperitoneal chemotherapy (HIPEC) [12]. So far, the largest experience on PIPAC-Ox included 17 patients with PM of colorectal origin having 48 PIPAC-Ox administrations (mean 2.8).…”

Bidirectional chemotherapy combining intraperitoneal docetaxel with intravenous 5-fluorouracil and oxaliplatin for patients with unresectable peritoneal metastasis from gastric cancer: the first study in Western countries

“…Fava et al [46] claimed that the most important effect of bidirectional chemotherapy based on taxanes seems to be the high response rate in PM extent. In our experience, at the first laparoscopy, the mean PCI was 34 [range [30][31][32][33][34][35][36][37][38][39], and it decreased to 18 [range [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] after the first bidirectional cycle, which was 48% less than the initial PCI (Table 2). This surprising result was better than the planned cut-off of 25% and suggested possible clinical benefits of bidirectional chemotherapy for PM of GC.…”

“…To our knowledge, this is the first Western study to evaluate the safety and efficacy of combined IP and IV chemotherapy for non-resectable PM from GC. Sgarbura et al [39] tested IP oxaliplatin in the neoadjuvant setting in patients presenting with unresectable PC of colorectal origin with encouraging results. The effects of IP taxane administration were analysed in phase II and III studies in advanced GC [12,13,16,17].…”