Advances with pharmacotherapy for peritoneal metastasis. (1st November 2020)

• Record Type: Journal Article
• Authors: Yonemura, Yutaka; Iahibashi, Haruaki; Sako, Shouzou; Mizumoto, Akiyoshi; Takao, Nobuyuki; Ichinose, Masumi; Motoi, Shunsuke; Liu, Yang; Wakama, Satoshi; Kamada, Yasuyuki; Nishihara, Kazurou
• Is Part Of: Expert opinion on pharmacotherapy. Volume 21:Number 16(2020)
• Page Start: 2057
• Page End: 2066
• Publication Date: 2020-11-01
• Subjects: Cytoreductive surgery -- hipec -- intraperitoneal chemotherapy -- peritoneal metastasis -- peritonectomy -- pharmacokinetics; Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1080/14656566.2020.1793957
• Languages: English
• ISSNs: 1465-6566

Abstract

ABSTRACT: Introduction: A new treatment strategy involving cytoreductive surgery (CRS) combined with perioperative intraperitoneal (IP) chemotherapy was proposed in 1999 by the Peritoneal Surface Oncology Group International, and the strategy is now justified as a state-of-the-art treatment to improve the long-term survival of patients with peritoneal metastasis (PM). To achieve cure in the patients with PM, complete removal of macroscopic tumors and eradication of micrometastasis on the peritoneum, left after CRS are essential. Systemic chemotherapy is not indicated for the treatment of PM. In contrast, intraperitoneal (IP) chemotherapy brings about significantly higher locoregional dose intensity in the peritoneal cavity and subperitoneal tissues. In combination with anticancer drugs, hyperthermia enhances cytotoxicity against cancer cells. Area covered: This article provides a systematic overview of PM from various cancers including gastric, colorectal, small bowel, appendiceal cancer, and mesothelioma. It also includes all the essential aspects of therapy. Expert opinion: CRS plus perioperative intraperitoneal chemotherapy is safe with acceptable morbidity and mortality. It is justified as a standard treatment to improve the long-term survival of patients with PM and is now performed with curative intent for PM from various malignancies.