Intraperitoneal chemohyperthermia (IPCH) with oxaliplatin for patients with colorectal peritoneal carcinomatosis

Abstract

3668 Background: To determine the activity and side-effect of intraperitoneal chemohyperthermia (IPCH) with oxaliplatin (LOHP), comparing with biweekly oxaliplatin, fluorouracil (FU) and leucovorin (LV) chemotherapy, as the therapy for patients with colorectal peritoneal carcinomatosis. Methods: 60 patients with measurable colorectal peritoneal carcinomatosis,proved pathologically, were divided into A and B groups at random. Group A: Patients were treated by IPCH with oxaliplatin 85 mg/m2, soluted in 500ml 5% GS, at an i.p. temperature of 42–44 degrees. Whereupon local radiofrequency hyperthermic chemotherapy was applied for 1 hours. Group B: Patients were treated with intravenous oxaliplatin 85 mg/m2 in 2 hours. During the hour preceding IPCH, all of them received an intravenous administration of 5-fluorouracil and leucovorin. The treatments were repeated every 2 weeks. One cycle lasts 30 days. Results: In group A, 27 patients can be evaluated. 2 patients achieved complete response, and 14 patients achieved partial response, for a response rate of 59.3%(95% CI, 29% to 68%). Median time to progression was 9.2 months (95% CI, 7.1 to 10.8 months) with median survival time of 11.1 months (95% CI, 8.4 to 19.7 months). In group B, 28 patients can be evaluated. 1 patients achieved complete response, and 9 patients achieved partial response, for a response rate of 35.7%(95% CI, 19% to 56%). Median time to progression was 7.0 months(95% CI, 4.1 to 12.5 months) with median survival time of 9.7 months(95% CI, 6.5 to 18.2 months).The response rate of ascites treatment was 86.7% with significant differences between two groups (P<0.05). Major toxicities included cumulative neuropathy grade 2 (9.4%) and grade 3 (1.2%); requiring discontinuation of oxaliplatin), diarrhea grade 3 to 4 (15.3%) and grade 3 to 4 hematologic toxicity (2.4%). Abdominal discomfort was significant(85.9%,p<0.05). Conclusions: The regimen of intraperitoneal chemohyperthermia (IPCH) with oxaliplatin (LOHP) seems to have activity comparable to intravenous programs of LOHP, combined with 5-fluorouracil and leucovorin. All side effects were tolerable. Prospective trials are warranted to determine the result. No significant financial relationships to disclose.