Impact of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy on Systemic Toxicity

Abstract

CRS+HIPEC presented acceptable systemic toxicity and PRM rates. Independent risk factors for systemic toxicity were the CDDP+Dx schedule and CDDP dose for HIPEC.

Hyperthermic intraperitoneal chemotherapy with cisplatin: Amifostine prevents acute severe renal impairment

“…16e18 Doses of CP of >240 mg are an independent risk factor for a large rise in postoperative serum creatinine concentrations. 16 A borderline correlation has been reported between these doses and the increase in serum creatinine concentrations (OR 3.021, CI 95%, 0.981e9.304; p ¼ 0.054). 16 In our study, with the criterion used to define severe renal impairment (measured CreatCl < 30 ml/min), the incidence was 13% in group Aþ compared to 33% in group AÀ (p ¼ 0.04).…”

Sitoreduktif Cerrahi ve HIPEK’te Anestezi ve Perioperatif Bakim

“…Renal fonksiyonların idame ettirilmesi ve renal zedelenmenin önlenmesi perioperatif sonuçları olumlu etkiler. HİPEK sırasında nefrotoksik kemoterapötiklerin kullanımı, abdominal hipertansiyon ve abdominal sıvı geçişine bağlı intravasküler volüm açığı nedeniyle %1.3-%5.7 hastada akut böbrek hasarı görülmektedir (10). Böbrek hasarı genellikle multi-faktöriyeldir.…”

Early and long-term postoperative management following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

“…The intracavitary perfusate temperature was 42℃-43℃. Drug dosage was reduced by 30% in patients > 70 years of age or who had undergone previous chemotherapy [42] . In 29 patients, 34 G3-5 systemic toxicity events occurred (NCI CTCAE v3), accounting for a toxicity rate of 11.7%.…”

“…Glehen observed a postoperative renal failure rate of 1.3% [11] . Hematological toxicity rates, according to most authors, range from 2.5 to 19 [10][11][12]21,22,35,[42][43][44] . Only one study presented an outlier value of 48% [13] .…”

“…Jacquet et al [21] , 1996 60 MMC 60 7 -5 Not identified Schnake et al [44] , 1999 242 MMC/CDDP Yes 2.5 -4 Not identified Stephens et al [10] , 1999 200 MMC 145 4 -1.5 Not identified Glehen et al [11] , 2003 216 MMC or CDDP or CDDP + MMC -4.6 1.3 3.2 NA Verwaal et al [22] , 2004 102 MMC -18.6 4.9 8 NA Shen et al [35] , 2004 77 MMC -19 -4 NA Smeenk et al [12] , 2006 103 MMC -10.6 -11 NA Elias et al [43] , 2005 83 Ox + CPT11 + ev 5-FU + AF -48 -4.8 Duration of proc; PCI Kusamura et al [42] , . The incidence of severe bone marrow aplasia was 48% and was associated with the duration of surgery and extent of the peritoneal disease [43] .…”