Intraperitoneal cisplatin and etoposide in peritoneal mesothelioma: favorable outcome with a multimodality approach.
Ten patients with histologically documented peritoneal mesothelioma were treated with intraperitoneal cisplatin 200 mg/m2, sodium thiosulfate rescue and etoposide 65-290 mg/m2 every 4 weeks for a maximum of six cycles. All had epithelial or mixed epithelial-fibrous histology. Toxicity was tolerable, with 50% sustaining grade 3 or 4 granulocytopenia. There was one episode of neutropenic fever. Grade 2 peripheral neuropathy occurred in one patient, grade 1 in five patients. Complete remission occurred in one of five patients with measurable disease. Median survival for patients whose tumors were surgically debulked to < 2 cm residua prior to treatment was 22 months, while it was 5 months for those with measurable, surgically inaccessible disease (P = 0.0731 by Cox regression proportional hazard model). These data suggest that patients who present with resectable disease may benefit from an aggressive adjuvant approach. This possibility warrants prospective testing in a randomized clinical trial.
Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111.
C J
CJ
Langer
N
N
Rosenblum
M
M
Hogan
S
S
Nash
P
P
Bagchi
F P
FP
LaCreta
R
R
Catalano
R L
RL
Comis
P J
PJ
O'Dwyer
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000628:therapy; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome
D005047:Etoposide; D002945:Cisplatin