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Intraperitoneal chemotherapy with mitoxantrone in malignant ascites.
K H Link1, M Roitman, M Holtappels
1Department of Visceral and Oncologic Surgery, Asklepios Paulinen Klinik and Asklepios, Tumor Center Rhein-Main (ATC), Geisenheimer Str. 10, D 65197 Wiesbaden, Germany. k-h.link.@asklepios.com
Surgical Oncology Clinics of North America
|October 22, 2003
Summary
Intraperitoneal mitoxantrone effectively treats malignant ascites in advanced breast and gynecologic cancers, offering palliative benefits with a low incidence of severe side effects. Recommended dosage is 30 mg in at least 1000 mL carrier solution.
Area of Science:
- Oncology
- Palliative Care
- Cancer Therapeutics
Background:
- Malignant ascites is a common complication in advanced breast and gynecologic cancers, significantly impacting patient quality of life.
- Intraperitoneal chemotherapy is a recognized approach for managing malignant ascites, aiming for local tumor control and symptom relief.
Purpose of the Study:
- To evaluate the efficacy and safety of intraperitoneal mitoxantrone instillation for malignant ascites in patients with advanced breast and gynecologic pelvic cancers.
- To confirm previously suggested palliative effects from smaller phase II trials.
Main Methods:
- Retrospective analysis of 143 patients (37 breast cancer, 106 gynecologic cancers) who received 257 intraperitoneal mitoxantrone instillations.
- Data collected on treatment response, clinical and laboratory side effects, and dose-dependent adverse event induction.
Main Results:
- Response rates were 49% for breast cancer and 63% for gynecologic cancer.
- Severe or life-threatening side effects occurred in 2.7% (clinical) and 1.9% (laboratory) of instillations.
- Adverse side effect induction was found to be dose-dependent.
Conclusions:
- Intraperitoneal mitoxantrone is an effective and well-tolerated chemotherapy option for malignant ascites in advanced breast and gynecologic malignancies.
- A recommended treatment involves 30 mg of mitoxantrone in ≥1000 mL of carrier solution, achieving a minimal concentration of 10 µg/mL.