Update on Chemotherapeutic Agents Utilized for Perioperative Intraperitoneal Chemotherapy

Abstract

A new strategy currently under evaluation in patients with peritoneal carcinomatosis from gastrointestinal and gynecologic cancers is perioperative intraperitoneal chemotherapy. Although results to date show benefit to carefully selected groups of patients, continued local-regional failure is seen in many treated patients. Continued clinical and laboratory research efforts to improve local-regional effects are desired. The chemotherapeutic agents that have been used in the past or are currently being tested were reviewed. Their pharmacologic properties and clinical features were collected from the medical literature and are reviewed in the text. An organized presentation of available data concerning the drugs available for perioperative intraperitoneal chemotherapy for peritoneal surface malignancy was made. From this review, new possibilities for improved doses, schedules, and drug combinations for perioperative intraperitoneal chemotherapy may become important in future clinical studies. Continued optimal utilization of intraperitoneal chemotherapy treatments in the operating room with hyperthermia or normothermic treatment in the early postoperative period is desirable. Innovative treatment strategies can improve the outcome of patients with peritoneal surface malignancy. The Oncologist

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“…The peritoneal cavity acts as a sanctuary against systemic chemotherapy, probably because of the existence of a blood-peritoneal barrier consisting of stromal tissue between mesothelial cells and submesothelial blood capillaries (Sugarbaker et al, 2005). This barrier acrosses for a total thickness of 90 µm (Baron, 1941).…”

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“…Most researchers calculate both drug dose and carrier solution volume based on body surface area (mg/m 2 ). Common perfusate volumes are 1.5 L/ m 2 or 2 L/m 2 [39,40]. The total volume of intraperitoneal chemotherapy can vary widely between individuals and gender difference in peritoneal surface area can affect absorption characteristics.…”

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