Current Applications of Intraperitoneal Chemotherapy

Peritoneal carcinomatosis presents significant therapeutic challenges due to the unique characteristics of peritoneal metastases, such as their widespread nature, variability in size, and limited blood supply. Intraperitoneal chemotherapy (IPC) was first introduced in 1955 as a targeted treatment modality to address these challenges. By delivering cytotoxic agents directly into the peritoneal cavity, IPC enhances drug concentration at tumor sites while minimizing systemic toxicity. Two primary methods of IPC are Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Early Postoperative Intraperitoneal Chemotherapy (EPIC), each with distinct protocols and advantages. HIPEC is administered during cytoreductive surgery under hyperthermic conditions, while EPIC is applied post-surgery over an extended period. Patient selection is critical, and the technique is most effective when tumor burden is manageable post-cytoreduction. This review explores the molecular properties of IPC agents, their clinical applications across various cancers, adverse effects, and long-term outcomes, highlighting IPC's potential as a life-saving treatment for patients with peritoneal metastases.