Intraperitoneal chemohyperthermia with mitomycin C for digestive tract cancer patients with peritoneal carcinomatosis.
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).
Beaujard
A C
AC
Oncologic Hyperthermia Laboratory, Université C.B. Lyon-I, Oullins, France.
Glehen
O
O
Caillot
J L
JL
Francois
Y
Y
Bienvenu
J
J
Panteix
G
G
Garbit
F
F
Grandclément
E
E
Vignal
J
J
Gilly
F N
FN
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002277:Carcinoma / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D004867:Equipment Design; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation / Q000379:methods*; D007263:Infusions, Parenteral / Q000379:methods; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000493:pharmacokinetics / Q000627:therapeutic use*; D010534:Peritoneal Neoplasms / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D015996:Survival Rate
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin