[Two cases of pseudomyxoma peritonei that responded to intraperitoneal administrations of a combined CDDP, 5-FU and...

Pseudomyxoma peritonei, which is the seeding of the peritoneum by mucin-secreting metastatic deposits and the filling of the peritoneal cavity by these secretions, is a malignancy that even after excision of the metastatic areas has a poor prognosis, since no effective therapy has yet been established. Herein, we report two cases of pseudomyxoma peritonei that responded to a combined postsurgical therapy consisting of CDDP, 5-FU and MMC. Case 1 involved a 56-year-old woman who underwent an appendectomy, a bilateral ovariectomy, and an omentectomy, due to pseudomyxoma peritonei. Further, a subcutaneous implant-type reservoir was sited intraperitoneally for postoperative chemotherapy. At 30 days after surgery, therapy commenced, consisting of 100 mg of CDDP and 20 mg of MMC administered intraperitoneally and 1,000 mg of 5-FU continuously infused by intravenous drip. This combined therapy was given for 5 days and repeated 8 times. As a result, the serum CEA value, which had elevated postoperatively, fell within the respective normal range, and at 4 years postoperatively, this patient remains alive. Case 2 concerns a 59-year-old woman who underwent an appendectomy, a right ovariectomy, and an omentectomy due to pseudomyxoma peritonei, and was postoperatively given 50 mg intraperitoneal administration of CDDP. She received 2 courses of postoperative chemotherapy similar to that given case 1 but with the addition of a 500 mg 5-FU intraperitoneally. At 8 months postoperatively, she is alive and disease-free. Given the above results, intraperitoneal administrations of this combined CDDP-5-FU-MMC therapy may be effective for patients with pseudomyxoma peritonei.