Treatment of peritoneal carcinomatosis by continuous hyperthermic peritoneal perfusion with cisplatin

There is considerable clinical and experimental evidence to suggest that the intraperitoneal administration of cisplatin via continuous hyperthermic peritoneal perfusion (CHPP) has potential clinical efficacy. The treatment is ideally suited for patients with small-volume peritoneal implants but technically appears to provide the best method of uniformly distributing hyperthermia and chemotherapy to the entire peritoneal cavity. In addition, preclinical data suggest that clinically attainable temperatures and a relatively brief exposure are sufficient for significant cell killing. Further work exploring the possibility of combining biologic agents with chemotherapy in this setting or the use of systemic agents used in combination with CHPP is needed. The technique is also attractive because of the relative technical ease with which it can be administered. If initial phase I and phase II studies demonstrate a therapeutic effect using this approach, then clearly large-scale multiinstitutional phase III studies will be required to established its therapeutic potential.