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

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.