The use of peritoneal dialysis for delivery of chemotherapy to intraperitoneal malignancies

We have utilized peritoneal dialysis via semipermanent Tenckhoff catheters to administer methotrexate and 5-fluorouracil to 16 patients with cancer whose tumor was confined to the intraabdominal space. The method of dialysis is described. The therapy was well tolerated by the patients. The major risks were bacterial peritonitis, local drug-induced peritonitis, and the systemic effects of the drugs. Theoretic modeling predicted that far greater concentrations of drug can be safely delivered by this route with less toxicity than when lower concentrations are administered by conventional routes. Furthermore, much higher concentrations should be achieved in the dialysate to which the tumor is exposed than in the systemic plasma. These predictions were confirmed.