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Intraperitoneal therapy for peritoneal tumors: biophysics and clinical evidence

Wim Ceelen UGent and Michael F Flessner (2010) NATURE REVIEWS CLINICAL ONCOLOGY. 7(2). p.108-115
abstract
In patients with tumors confined to the peritoneal cavity, there is established pharmacokinetic and tumor biology-related evidence that intraperitoneal drug administration is advantageous. Three large randomized trials in patients with stage III ovarian cancer who underwent optimal cytoreduction have demonstrated a significant survival benefit when intraperitoneal chemotherapy was added to systemic therapy. Although intraperitoneal therapy is associated with locoregional toxic effects, recent trials suggest that with some modification of the local delivery methods this approach is safe in 80% of patients in an ambulatory setting. Surgical cytoreduction immediately followed by intraoperative hyperthermic intraperitoneal chemoperfusion (HIPEC) ensures intraperitoneal delivery of the drug to all peritoneal surfaces and the advantages of combined hyperthermia to be exploited. An increasing number of centers are initiating this multimodality therapy in ovarian cancer and colorectal cancer. Clearly, intraperitoneal drug delivery is an important adjunct to surgery and systemic chemotherapy in selected patients. The optimal drug, dose and schedule for intraperitoneal delivery, the exact role of added HIPEC compared with cytoreduction alone, and the potential role of HIPEC in ovarian cancer and peritoneal mesothelioma are still undefined. Several randomized controlled trials addressing these uncertainties have been initiated.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (review)
publication status
published
subject
keyword
PHASE-III TRIAL, OVARIAN-CARCINOMA CELLS, GYNECOLOGIC-ONCOLOGY-GROUP, CYTOREDUCTIVE SURGERY, COLORECTAL-CANCER, PSEUDOMYXOMA PERITONEI, SYSTEMIC CHEMOTHERAPY, INTRAVENOUS CISPLATIN, SOLID TUMORS, HYPERTHERMIC CHEMOTHERAPY
journal title
NATURE REVIEWS CLINICAL ONCOLOGY
Nat. Rev. Clin. Oncol.
volume
7
issue
2
pages
108 - 115
Web of Science type
Review
Web of Science id
000274082600012
JCR category
ONCOLOGY
JCR impact factor
10.787 (2010)
JCR rank
7/181 (2010)
JCR quartile
1 (2010)
ISSN
1759-4774
DOI
10.1038/nrclinonc.2009.217
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
5710784
handle
http://hdl.handle.net/1854/LU-5710784
date created
2014-09-25 15:52:39
date last changed
2016-12-19 15:46:46
@article{5710784,
  abstract     = {In patients with tumors confined to the peritoneal cavity, there is established pharmacokinetic and tumor biology-related evidence that intraperitoneal drug administration is advantageous. Three large randomized trials in patients with stage III ovarian cancer who underwent optimal cytoreduction have demonstrated a significant survival benefit when intraperitoneal chemotherapy was added to systemic therapy. Although intraperitoneal therapy is associated with locoregional toxic effects, recent trials suggest that with some modification of the local delivery methods this approach is safe in 80\% of patients in an ambulatory setting. Surgical cytoreduction immediately followed by intraoperative hyperthermic intraperitoneal chemoperfusion (HIPEC) ensures intraperitoneal delivery of the drug to all peritoneal surfaces and the advantages of combined hyperthermia to be exploited. An increasing number of centers are initiating this multimodality therapy in ovarian cancer and colorectal cancer. Clearly, intraperitoneal drug delivery is an important adjunct to surgery and systemic chemotherapy in selected patients. The optimal drug, dose and schedule for intraperitoneal delivery, the exact role of added HIPEC compared with cytoreduction alone, and the potential role of HIPEC in ovarian cancer and peritoneal mesothelioma are still undefined. Several randomized controlled trials addressing these uncertainties have been initiated.},
  author       = {Ceelen, Wim and Flessner, Michael F},
  issn         = {1759-4774},
  journal      = {NATURE REVIEWS CLINICAL ONCOLOGY},
  keyword      = {PHASE-III TRIAL,OVARIAN-CARCINOMA CELLS,GYNECOLOGIC-ONCOLOGY-GROUP,CYTOREDUCTIVE SURGERY,COLORECTAL-CANCER,PSEUDOMYXOMA PERITONEI,SYSTEMIC CHEMOTHERAPY,INTRAVENOUS CISPLATIN,SOLID TUMORS,HYPERTHERMIC CHEMOTHERAPY},
  language     = {eng},
  number       = {2},
  pages        = {108--115},
  title        = {Intraperitoneal therapy for peritoneal tumors: biophysics and clinical evidence},
  url          = {http://dx.doi.org/10.1038/nrclinonc.2009.217},
  volume       = {7},
  year         = {2010},
}

Chicago
Ceelen, Wim, and Michael F Flessner. 2010. “Intraperitoneal Therapy for Peritoneal Tumors: Biophysics and Clinical Evidence.” Nature Reviews Clinical Oncology 7 (2): 108–115.
APA
Ceelen, Wim, & Flessner, M. F. (2010). Intraperitoneal therapy for peritoneal tumors: biophysics and clinical evidence. NATURE REVIEWS CLINICAL ONCOLOGY, 7(2), 108–115.
Vancouver
1.
Ceelen W, Flessner MF. Intraperitoneal therapy for peritoneal tumors: biophysics and clinical evidence. NATURE REVIEWS CLINICAL ONCOLOGY. 2010;7(2):108–15.
MLA
Ceelen, Wim, and Michael F Flessner. “Intraperitoneal Therapy for Peritoneal Tumors: Biophysics and Clinical Evidence.” NATURE REVIEWS CLINICAL ONCOLOGY 7.2 (2010): 108–115. Print.