New principles, better practices, and clearer perceptions in intraperitoneal chemotherapy: clinical experience using icodextrin 20 as a carrier solution

Adv Perit Dial. 1997:13:162-7.

Abstract

The rationale for using intraperitoneal chemotherapy is based on three phenomena: certain types of tumor are confined to the abdominal cavity for many years; the ability to deliver the drug directly to the surface of tumor deposits; the pharmacological advantage of attaining high local concentrations of the drug within the cavity. Current techniques of intraperitoneal chemotherapy do not use a specially designed carrier solution, which greatly restricts flexibility and does not permit continuous ambulatory intraperitoneal chemotherapy necessary for optimal use of cell cycle-specific antitumor agents. Using icodextrin 20 as a carrier solution containing 50% of the dose of 5-fluorouracil in a 24-hour dwell, simultaneously with a 24-hour elastomeric infusor device containing 50% of the dose, we have succeeded in carrying out continuous ambulatory intraperitoneal chemotherapy, 5 days out of 7 for up to 12 weeks, exposing the peritoneal contents to drug concentrations a thousand-fold greater than attained in the serum in a Phase I clinical trial. These studies have for the first time demonstrated that it is possible to expose continuously for long periods intraperitoneal tumor deposits to sustained high levels of cell cycle-specific cytotoxic agents.

MeSH terms

  • Antineoplastic Agents / administration & dosage*
  • Clinical Trials as Topic
  • Dialysis Solutions*
  • Drug Carriers
  • Fluorouracil / administration & dosage
  • Glucans / administration & dosage*
  • Glucose / administration & dosage*
  • Humans
  • Icodextrin
  • Infusions, Parenteral*
  • Peritoneal Neoplasms / drug therapy*

Substances

  • Antineoplastic Agents
  • Dialysis Solutions
  • Drug Carriers
  • Glucans
  • Icodextrin
  • Glucose
  • Fluorouracil