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

• Published in: Cancer 2000-06, Vol.88 (11), p.2512-2519
• Main Authors: Beaujard, Annie C., Glehen, Olivier, Caillot, Jean L., Francois, Yves, Bienvenu, Jacques, Panteix, Gilles, Garbit, Florence, Grandclément, Eric, Vignal, Jacques, Gilly, François N.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibiotics, Antineoplastic - pharmacokinetics; Antibiotics, Antineoplastic - therapeutic use; Carcinoma - metabolism; Carcinoma - mortality; Carcinoma - therapy; Combined Modality Therapy; digestive tract cancer; Equipment Design; Female; Gastrointestinal Neoplasms - metabolism; Gastrointestinal Neoplasms - mortality; Gastrointestinal Neoplasms - therapy; Gastrointestinal Tract; Humans; hyperthermia; Hyperthermia, Induced - instrumentation; Hyperthermia, Induced - methods; Infusions, Parenteral - methods; intracavitary hyperthermia; intraperitoneal chemotherapy; Male; Middle Aged; Mitomycin - pharmacokinetics; Mitomycin - therapeutic use; peritoneal carcinomatosis; Peritoneal Neoplasms - metabolism; Peritoneal Neoplasms - mortality; Peritoneal Neoplasms - therapy; Prospective Studies; Survival Rate
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(20000601)88:11<2512::AID-CNCR12>3.0.CO;2-J

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 °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). Cancer 2000;88:2512–19. © 2000 American Cancer Society. From this Phase II study, intraperitoneal chemohyperthermia seems to be a possible new device for peritoneal carcinomatosis of digestive tract origin, especially when malignant granulations are less than 5 mm in greatest dimension.