Ovarian cancer with peritoneal carcinomatosis: Comparing of photodynamic treatment and HIPEC.

Abstract

e17040 Background: Peritoneal carcinomatosis is a very common by ovarian cancer (OC). Usual treatment`s approaches such as systemic drugs are not very effective. 5-year survival by OC depends of stage and are 15-20% in III stage and only 5% in IV stage. Most part of this patients die with progression of peritoneal disease. Standart treatment`s approach by OC is radical surgery with adjuvant chemotherapy. But in many cases this tactic can`t control peritoneal lesions and, therefore, outcomes. Methods: In our oncology center we are performing retrospective non-randomized prospective study comparing two different treatment options by ovarian`s peritoneal carcinomatosis - photodynamic therapy (PDT) and hyperthermic intraperitoneal chemotherapy (HIPEC). There were 25 patients in PDT-group and 21 patients in HIPEC-group. Treatment in PDT-group included 2-4 cycles of neo-adjuvant chemotherapy (cyclophosphamid+cisplatinum /CP/, n=7 or paclitaxel+cisplatinum /TC/, n=18 ), after which we performed surgery+PDT and then 4-6 cycles same chemotherapy. We used iv. photolon (Russia) as photosensitizer and 630-680 nm diod laser. Time of procedure was 20 minutes. Peritoneal Carcinomatosis Index (PCI) was 4,2 an averege (1-12). Treatment in HIPEC-group included 2-4 cycles of neo-adjuvant chemotherapy (cyclophosphamid+cisplatinum /CP/, n=21), after which we performed surgery+HIPEC and then 4-6 cycles the same chemotherapy. Medium PCI was 5,6 (2-11). We used “closed” HIPEC technique, with 3 inflow and 3 outflow catheters, Performer HT device by RanD and 7 liters of saline solution with 200 mg cisplatunum or 100 mg/m2 taxans were used. Results: There were 11 recurrence in PDT-group (44%) and 10 recurrence in HIPEC-group (38%), t=1,06. Median of time to progression was 11.6 months in PDT-group and 13,5 months in HIPEC-group. Median of overall surviving was 18,4 and 24,1 months respectively. Conclusions: Using of PDT by ovarian cancer with peritoneal carcinomatosis didn`t show increasing of overall survival. We can also notice the non-statistical tendency of increasing time to progression in HIPEC-group. We run our study further and hope to collect more data for analysis.

Validation of thermal dynamics during Hyperthermic IntraPEritoneal Chemotherapy simulations using a 3D-printed phantom

“…Peritoneal metastasis (PM) originating from primary gastric, ovarian or colorectal cancer are often associated with poor survival (1)(2)(3). In general, we can identify three treatment strategies: systemic chemotherapy, surgery and cytoreductive surgery followed by Hyperthermic IntraPeritoneal Chemotherapy (HIPEC).…”