Generic placeholder image

Current Drug Discovery Technologies


ISSN (Print): 1570-1638
ISSN (Online): 1875-6220

Using Pharmacologic Data to Plan Clinical Treatments for Patients with Peritoneal Surface Malignancy

Author(s): Kurt Van der Speeten, Oswald Anthony Stuart and Paul H. Sugarbaker

Volume 6 , Issue 1 , 2009

Page: [72 - 81] Pages: 10

DOI: 10.2174/157016309787581084

Price: $65


The surfaces of the abdomen and pelvis are an important anatomic site for the dissemination of gastrointestinal and gynecologic malignancy. This transcoelomic spread of cancer cells gives rise to peritoneal carcinomatosis which, without special treatments, is a fatal manifestation of these diseases. In order to control peritoneal carcinomatosis cytoreductive surgery to remove gross disease is combined with perioperative intraperitoneal and perioperative intravenous chemotherapy to eradicate microscopic residual disease. Chemotherapy agents are selected to be administered by the intraperitoneal or intravenous route based on their pharmacologic properties. A peritoneal- plasma barrier which retards the clearance of high molecular weight chemotherapy from the peritoneal cavity results in a large exposure of small cancer nodules on abdominal and pelvic surfaces. Tissue penetration is facilitated by moderate hyperthermia (41-42°C) of the intraperitoneal chemotherapy solution. A constant dose of chemotherapy agent and volume of carrier solution based on body surface area allows prediction of systemic drug exposure and systemic toxicity. Timing of the chemotherapy as a planned part of the surgical procedure to maximize exposure of all peritoneal surfaces is crucial to success.

Keywords: Intraperitoneal chemotherapy, 5-fluorouracil, doxorubicin, mitomycin C, peritoneal-plasma barrier, appendiceal cancer, colorectal cancer, peritoneal mesothelioma, ovarian cancer

Rights & Permissions Print Export Cite as
© 2022 Bentham Science Publishers | Privacy Policy