title: A comparison of hematologic toxicity profiles after heated intraperitoneal chemotherapy with oxaliplatin and mitomycin C.
abstract: BACKGROUND
  Although peritoneal carcinomatosis (PC) from colorectal and appendiceal tumors is consistent with metastatic disease, complete cytoreduction with hyperthermic intraperitoneal chemotherapy (HIPEC) using mitomycin C (MMC) can improve survival. A recent phase I study by our group using hyperthermic intraperitoneal oxaliplatin has demonstrated its safety and appropriate dose. Our goal in this study is to present a single institution's experience with the hematologic toxicities of the two agents.
  
  
  METHODS
  We performed a retrospective review of 187 patients with PC of colorectal or appendiceal origin who underwent HIPEC with MMC or oxaliplatin between October 2006 and September 2009. Hematologic toxicities were graded according to the NCI Common Terminology Criteria for Adverse Events Version 4.0.
  
  
  RESULTS
  Of the 187 patients, 55 had oxaliplatin-based HIPEC while 132 patients received MMC. Splenectomy was performed in 95 patients (50.8%) due to disease involvement. When comparing hematologic toxicity for MMC and oxaliplatin among the cohort of patients who underwent splenectomy, a statistically significant difference was noted in the incidence of platelet (P = .02) and neutrophil (P = .05) toxicity, with oxaliplatin having a higher incidence of grade 3 and grade 4 platelet and neutrophil toxicity respectively. However, no statistically significant difference in hematologic toxicity was noted between the two agents in patients who did not undergo splenectomy during cytoreductive surgery.
  
  
  CONCLUSIONS
  Oxaliplatin-based HIPEC for PC of colorectal and appendiceal origin is associated with similar white blood cell toxicity and higher platelet and neutrophil toxicity compared to MMC-based HIPEC.
authors.affiliation: Department of General Surgery, Surgical Oncology Section, Wake Forest School of Medicine, Winston-Salem, North Carolina. kvotanop@wakehealth.edu
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Votanopoulos
authors.forename: Chukwuemeka
authors.initials: C
authors.lastname: Ihemelandu
authors.forename: Perry
authors.initials: P
authors.lastname: Shen
authors.forename: John
authors.initials: J
authors.lastname: Stewart
authors.forename: Gregory
authors.initials: G
authors.lastname: Russell
authors.forename: Edward A
authors.initials: EA
authors.lastname: Levine
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001063:Appendiceal Neoplasms / Q000473:pathology; D001792:Blood Platelets / Q000473:pathology; D015179:Colorectal Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D009504:Neutrophils / Q000473:pathology; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D000077150:Oxaliplatin; D010534:Peritoneal Neoplasms / Q000097:blood* / Q000556:secondary / Q000628:therapy*; D012189:Retrospective Studies; D013156:Splenectomy; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D016685:Mitomycin