title: Intraperitoneal chemohyperthermia with mitomycin C for digestive tract cancer patients with peritoneal carcinomatosis.
abstract: 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).
authors.affiliation: Oncologic Hyperthermia Laboratory, Université C.B. Lyon-I, Oullins, France.
authors.forename: A C
authors.initials: AC
authors.lastname: Beaujard
authors.forename: O
authors.initials: O
authors.lastname: Glehen
authors.forename: J L
authors.initials: JL
authors.lastname: Caillot
authors.forename: Y
authors.initials: Y
authors.lastname: Francois
authors.forename: J
authors.initials: J
authors.lastname: Bienvenu
authors.forename: G
authors.initials: G
authors.lastname: Panteix
authors.forename: F
authors.initials: F
authors.lastname: Garbit
authors.forename: E
authors.initials: E
authors.lastname: Grandclément
authors.forename: J
authors.initials: J
authors.lastname: Vignal
authors.forename: F N
authors.initials: FN
authors.lastname: Gilly
mesh_terms: 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
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin