Hyperthermic intraoperative intreperitoneal chemotherapy (HIIC) with mitomycin C.
Dedrick et al. published a mathematical model in 1978 that described the theoretical rationale for in- traperitoneal administration of chemotherapeutic agents.' Numerous authors have provided substantial clinical and experimental evidence supporting Dedrick's model. Lukas et al.' and Torres et al.' have de- scribed the pharmacokinetics involved in the transport of drugs from the peritoneal cavity into the portal and systemic circulation. These investigations and others gave birth to the pharmacologic concept known as the peritoneal plasma barrier (PPB). The PPB has been described as a complex diffusion barrier, consisting of the endothelium, the mesothelium, and the intervening interstitium, along with the fluid in the blood and the dialysate.t This physiologic barrier limits the resorption of hydrophilic drugs such as mitomycinC, doxoru- bicin, and cisplatin from the peritoneal cavity into the blood.
Sugarbaker
P H
PH
Gastrointestinal Oncology Program, Washington Cancer Institute, Washington, DC, USA.
Averbach
A M
AM
Jacquet
P
P
Stuart
O A
OA
Stephens
A D
AD