Intraperitoneal hyperthermic chemotherapy in ovarian cancer

Abstract

We investigated the effect of intraperitoneal hyperthermic perfusion chemotherapy as consolidation therapy in stage IIIB-IIIC ovarian cancer, following cytoreductive surgery and systemic chemotherapy (cisplatin-cyclophosphamide--six cycles). Disease-free survival, overall survival, and side effects were compared with a control group of patients who refused a second-look surgery and intraperitoneal chemotherapy. In a multicenter prospective trial, 29 patients with complete or optimal cytoreductive surgery and systemic treatment were included in the consolidation group and received intraperitoneal hyperthermic perfusion chemotherapy. Patients were recruited between January 1991 and December 1997. The intraperitoneal hyperthermic perfusion was performed with open-abdomen technique, using physiologic solution containing cisplatin 100 mg/m2, for 60 min in hyperthermic phase (41-43 degrees C). Intraperitoneal hyperthermic perfusion chemotherapy was locally and systemically well tolerated. The consolidation therapy group showed a better 5-year survival rate and lower recurrent disease rate, but differences were not statistically significant. Our results suggest that intraperitoneal hyperthermic perfusion chemotherapy is a feasible, well-tolerated, and promising alternative as consolidation therapy in ovarian cancer.

Hyperthermic intra-peritoneal chemotherapy using Oxaliplatin as consolidation therapy for advanced epithelial ovarian carcinoma. Results of a phase II prospective multicentre trial. CHIPOVAC study

“…In a multicenter prospective trial, 29 patients with complete or optimal cytoreductive surgery and systemic treatment were included in the consolidation group and received HIPEC using cisplatin 100 mg/m2, for 60 min. The consolidation therapy group showed a better 5-year survival rate and lower recurrent disease rate, but differences were not statistically significant (19). Our inclusion criteria included patients with poor prognostic factors: suboptimal (incomplete) debulking at first time laparotomy or positive second look.…”

Preparation and biodistribution of 188Re-labeled folate conjugated human serum albumin magnetic cisplatin nanoparticles (188Re-folate-CDDP/HSA MNPs) in vivo

“…However, because intraperitoneal chemohyperthermia is an invasive method, and both targeted chemotherapy and thermotherapy have some disadvantages, adverse effects are inevitable. In addition, many complications have occurred when intraperitoneal chemohyperthermia has been used clinically, including intestinal obstruction, 8 anastomotic leakage 8,9 renal damage, 9 and bone marrow inhibition, 10,11 which has limited the wider clinical application of this technology. The National Surgical Adjuvant Breast and Bowel Project and American College of Surgeons Oncology Group have organized several research programs to address some of the fundamental problems of intraperitoneal chemohyperthermia, in particular to improve the heating equipment and methods used to measure and maintain deep layer temperature accurately, to increase the effective target orientation, and decrease the side effects of chemotherapy.…”

Does Hyperthermic Intraperitoneal Perfusion Affect the Outcome After Cytoreductive Surgery?

“…However, the patient 7 died on day 3 after the cytoreductive surgery because of the bleeding and hemorrhagic shock. (up to 54%) and mortality (up to 11%) [1,[4][5][6]8]. The most common post-operative complications are anastomotic leakage, gastrointestinal and pancreatic fistulas, pneumonia, thromboembolism, and abdominal abscess [14].…”

“…For example, even 20 years ago patients with pseudomyxoma peritonei were suggested only interval debulking to improve their quality of life but without a chance for a long-term survival [1]. Suggesting radical peritonectomy aimed at removing as much macroscopic disease as possible followed by HIPEC to eliminate microscopic and residual disease resulted in significant improvement of outcomes with 5-and 10-years survival being 40−87 and 50% to 74% respectively [2][3][4][5][6][7][8][9][10]. However, combination cytoreductive surgery + HIPEC are considered as a treatment modality with high rate of postoperative morbidity and mortality by some authors [11].…”