Intraperitoneal chemohyperthermia with mitomycin C for digestive tract cancer patients with peritoneal carcinomatosis

Cancer. 2000 Jun 1;88(11):2512-9. doi: 10.1002/1097-0142(20000601)88:11<2512::aid-cncr12>3.0.co;2-j.

Abstract

Background: Most patients with peritoneal carcinomatosis of digestive tract origin die within 6 months. Intraperitoneal chemohyperthermia (IPCH) associated with surgery has been reported as a possible new therapeutic approach.

Methods: A prospective Phase II trial was carried out with 83 patients who had digestive tract cancer and peritoneal carcinomatosis to evaluate the tolerance and efficacy of IPCH with mitomycin C (MMC) associated with surgery. Eighty-six IPCH treatments with MMC were given as complementary therapy after surgery (peritoneal perfusate with a 10 mg/L dose of MMC; inflow temperature, 46-49 degrees C; use of a closed circuit; duration, 90 minutes). Primary tumors were mainly gastric (in 42 cases) or colorectal (in 27 cases).

Results: Mortality and morbidity occurred in 3 of 83 cases and 8 of 83 cases, respectively. For patients with resectable tumors, the median survival time was 16 months when carcinomatosis was Stage I and II (malignant granulations less than 5 mm in greatest dimension), whereas it was 6 months when carcinomatosis was Stage III and IV (malignant granulations more than 5 mm in greatest dimension). For patients with resectable gastric cancer and Stage I and II carcinomatosis, 1-, 2-, and 3-year actuarial survival rates were 80%, 61%, and 41%, respectively, whereas the rate was 10% at 1 year for patients with bulky disease (Stage III and IV).

Conclusions: IPCH appears to be a promising new approach to treating patients with digestive tract cancers and peritoneal carcinomatosis with small, malignant granulations (Stage I and II).

Publication types

  • Clinical Trial
  • Clinical Trial, Phase II
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibiotics, Antineoplastic / pharmacokinetics
  • Antibiotics, Antineoplastic / therapeutic use*
  • Carcinoma / metabolism
  • Carcinoma / mortality
  • Carcinoma / therapy*
  • Combined Modality Therapy
  • Equipment Design
  • Female
  • Gastrointestinal Neoplasms / metabolism
  • Gastrointestinal Neoplasms / mortality
  • Gastrointestinal Neoplasms / therapy*
  • Humans
  • Hyperthermia, Induced / instrumentation
  • Hyperthermia, Induced / methods*
  • Infusions, Parenteral / methods
  • Male
  • Middle Aged
  • Mitomycin / pharmacokinetics
  • Mitomycin / therapeutic use*
  • Peritoneal Neoplasms / metabolism
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / therapy*
  • Prospective Studies
  • Survival Rate

Substances

  • Antibiotics, Antineoplastic
  • Mitomycin