Diffuse and gross peritoneal carcinomatosis treated by intraperitoneal hyperthermic chemoperfusion

Area of Science:

• Oncology
• Surgical Oncology
• Chemotherapy

Background:

• Peritoneal carcinomatosis presents a significant challenge in cancer treatment.
• Intraoperative intraperitoneal hyperthermic chemoperfusion (IHCP) offers potential advantages including uniform drug distribution and hyperthermia-induced cytotoxicity.
• Heat acts as both a cytotoxic agent and a biomodulator of chemotherapy.

Purpose of the Study:

• To evaluate the feasibility and efficacy of intraoperative intraperitoneal hyperthermic chemoperfusion (IHCP) in patients with diffuse and gross peritoneal carcinomatosis.
• To assess treatment response, side effects, and quality of life improvements.

Main Methods:

• A phase II study involving 25 patients with peritoneal carcinomatosis.
• IHCP administered with mitomycin C for gastrointestinal malignancies or cisplatin for ovarian cancer with malignant ascites.
• Evaluation of side effects, clinical response, pathohistologic remission, ascites reduction, tumor marker normalization, and quality of life.

Main Results:

• Fifteen out of 21 evaluable patients showed a favorable clinical response, with 3 achieving complete remission.
• Ascites resolved in 16 of 19 patients.
• Tumor markers normalized or decreased by over 50% in 13 patients, and quality of life improved significantly in responders.

Conclusions:

• Intraoperative intraperitoneal hyperthermic chemoperfusion (IHCP) is a feasible and effective treatment for peritoneal carcinomatosis.
• IHCP demonstrates significant efficacy in managing ascites, reducing tumor burden, and improving patient quality of life.
• While severe toxicities were observed in a minority of patients, the overall therapeutic benefits suggest IHCP as a valuable option in selected cases.