Article

Heated intra-operative intraperitoneal oxaliplatin alone and in combination with intraperitoneal irinotecan: Pharmacologic studies.

Department of Oncological Surgery, Institut Gustave Roussy Comprehensive Cancer Center, 39 Rue Camille Desmoulins, 94805 Villejuif, France.
European Journal of Surgical Oncology (impact factor: 2.5). 09/2006; 32(6):607-13. DOI:10.1016/j.ejso.2006.03.004 pp.607-13
Source: PubMed

ABSTRACT The results of four prospective clinical trials testing intraperitoneal chemohyperthermia (IPCH) are reported. The first one aimed at determining the appropriate dose of heated (42 degrees C) intraperitoneal oxaliplatin following complete resection of peritoneal carcinomatosis (PC) by studying its pharmacokinetics. The recommended dosage was set at 460 mg/m2 in 2 l/m2 of peritoneal instillation. The second trial is a phase 2 study on 24 patients with colorectal PC treated with the preceding regimen: the 2-year survival rate was 74% after a minimal follow-up of 18 months. A second pharmacokinetic study using intraperitoneal oxaliplatin at the same dose but in hypotonic solutions did not show any survival advantage and was associated with an increase in complications. A third pharmacokinetic study was to determine the appropriate dose of intraperitoneal oxaliplatin combined with intraperitoneal irinotecan: the recommended dosage was 360 mg/m2 for each of the chemotherapy agents.

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    Article: Is Platinum Present in Blood and Urine from Treatment Givers during Hyperthermic Intraperitoneal Chemotherapy?
    Sara Näslund Andréasson, Helena Anundi, Sig-Britt Thorén, Hans Ehrsson, Haile Mahteme
    [show abstract] [hide abstract]
    ABSTRACT: Background. In selected patients with peritoneal carcinomatosis (PC) originating from colorectal cancer (CRC) the high dosage of oxaliplatin (460 mg/m(2)) is recommended for hyperthermic intraperitoneal chemotherapy (HIPEC), which may be a health risk to those administering the drug. The aim of this study was to determine the risk of platinum (Pt) exposure for the two main people handling and administering the cytotoxic agent during HIPEC. Methods. Samples of blood and urine were collected from one male surgeon and one female perfusionist during oxaliplatin-based HIPEC treatment with open abdomen coliseum technique on six consecutive patients with PC from CRC. Results. All blood samples analysed were below the detection limit of <0.05 nmol/L Pt, and the urine samples were all below the detection limit of <0.03 nmol/L Pt. Conclusions. There appears to be little or no risk of Pt exposure during HIPEC when the recommended protective garment is used and the safety considerations are followed.
    Journal of Oncology 01/2010; 2010:649719.
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Keywords

2-year survival rate
 
42 degrees C
 
appropriate dose
 
chemotherapy agents
 
colorectal PC
 
complete resection
 
hypotonic solutions
 
intraperitoneal irinotecan
 
intraperitoneal oxaliplatin
 
minimal follow-up
 
peritoneal carcinomatosis
 
peritoneal instillation
 
pharmacokinetics
 
phase 2 study
 
preceding regimen
 
prospective clinical trials testing intraperitoneal chemohyperthermia
 
recommended dosage
 
second pharmacokinetic study
 
survival advantage
 
third pharmacokinetic study