Combined resection, intraperitoneal chemotherapy, and whole abdominal radiation for the treatment of malignant peritoneal mesothelioma Journal Article
| Authors: | Hesdorffer, M. E.; Chabot, J. A.; Keohan, M. L.; Fountain, K.; Talbot, S.; Gabay, M.; Valentin, C.; Lee, S. M.; Taub, R. N. |
| Article Title: | Combined resection, intraperitoneal chemotherapy, and whole abdominal radiation for the treatment of malignant peritoneal mesothelioma |
| Abstract: | Objective: We report a single-institution Phase I or II trial of surgical debulking, intraperitoneal chemotherapy, and immunotherapy followed by whole abdominal radiotherapy in patients with malignant peritoneal mesothelioma. Methods: Between 1997 and 2000, 27 patients with malignant peritoneal mesothelioma were enrolled: 23 with epithelial subtype and 4 with sarcomatoid or mixed subtype. The treatment regimen consisted of surgical debulking followed by 4 intraperitoneal courses of cisplatin alternating with 4 courses of doxorubicin, 4 doses of intraperitoneal gamma interferon, a second laparotomy with resection of residual disease plus intraoperative intraperitoneal mitomycin and cisplatin heated to 41°C, and finally whole abdominal radiotherapy. Results: The median overall survival was 70 months with a 3-year survival of 67% (95% confidence interval, 46%-81%). Fourteen patients have died of their disease with a median time to death of 17 months (range, 0.4-71 months) after consenting to treatment. Seven patients are alive without evidence of disease with a median follow-up of 90 months (range, 71-110 months), and 6 are alive with disease with a median follow-up of 86 months (range, 70-106 months). The regimen was well tolerated. There were no patients with Grade III or IV hematological toxicities, 2 patients with Grade III ototoxicity, and 3 patients with Grade III gastrointestinal toxicity. Conclusion: Based on the results of this study, intensive multimodality therapy appears feasible and effective in this group of patients. © 2008 by Lippincott Williams & Wilkins. |
| Keywords: | adult; clinical article; treatment outcome; aged; middle aged; antibiotic agent; cancer surgery; survival rate; overall survival; clinical trial; drug tolerability; histopathology; mortality; fistula; cisplatin; doxorubicin; cancer combination chemotherapy; multimodality cancer therapy; side effect; chemotherapy, adjuvant; combined modality therapy; follow up; methodology; follow-up studies; antineoplastic agent; laparotomy; cytoreductive surgery; pain; phase 2 clinical trial; peritoneal neoplasms; antineoplastic combined chemotherapy protocols; chill; gastrointestinal toxicity; feasibility study; immunotherapy; feasibility studies; adjuvant chemotherapy; mesothelioma; epithelium cell; nausea and vomiting; malignant neoplastic disease; temperature; therapy effect; resection; intestine ulcer; phase 1 clinical trial; mitomycin; catheter infection; room temperature; peritoneum mesothelioma; peritoneum tumor; intraperitoneal chemotherapy; small intestine obstruction; aspiration pneumonia; gamma1b interferon; ototoxicity; abdominal neoplasms; abscess; percocet; body ache; sympathetic dystrophy; abdominal tumor; intraperitoneal drug administration; injections, intraperitoneal |
| Journal Title: | American Journal of Clinical Oncology |
| Volume: | 31 |
| Issue: | 1 |
| ISSN: | 0277-3732 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2008-02-01 |
| Start Page: | 49 |
| End Page: | 54 |
| Language: | English |
| DOI: | 10.1097/COC.0b013e3180684181 |
| PUBMED: | 18376228 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 12" - "Export Date: 17 November 2011" - "CODEN: AJCOD" - "Source: Scopus" |
