Impact of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy on systemic toxicity
| Autor: | Myriam Favaro, Barbara Laterza, Rami Younan, Shigeki Kusamura, Pasqualina Costanzo, Grazia Daniela Oliva, Marcello Deraco, Cecilia Gavazzi, Dario Baratti, Federica Grosso |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Pulmonary toxicity Mitomycin Gastroenterology Nephrotoxicity Internal medicine Antineoplastic Combined Chemotherapy Protocols Medicine Humans Infusions Parenteral Adverse effect Peritoneal Neoplasms Aged Cisplatin business.industry Mitomycin C Hyperthermia Induced Middle Aged Combined Modality Therapy Logistic Models Treatment Outcome Oncology Bone marrow suppression Doxorubicin Anesthesia Toxicity Surgery Hyperthermic intraperitoneal chemotherapy Female Morbidity Neoplasm Recurrence Local business medicine.drug |
| Zdroj: | Annals of surgical oncology. 14(9) |
| ISSN: | 1068-9265 |
| Popis: | The purpose of this study was to analyze the postoperative systemic toxicity and procedure-related mortality (PRM) of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal surface malignancies (PSMs).A total of 242 (84 males/158 females) patients with PSM underwent 247 consecutive procedures. The mean age was 52 years (range 22-79). CRS was performed using peritonectomy procedures. The HIPEC technique through the closed abdomen was conducted with cisplatin (CDDP 25 mg/m(2)/l of perfusate)+mitomycin C (MMC 3.3 mg/m(2)/l perfusate) or CDDP (43 mg/l perfusate)+doxorubicin (Dx 15.25 mg/l perfusate) at 42.5 degrees C. These dosages were reduced by 30% when the patient had received systemic chemotherapy before the CRS+HIPEC. Systemic toxicities were graded according to the NCI CTCAE v3 criteria.G3-5 systemic toxicity rate was 11.7 % and adverse events were bone marrow suppression, 13; nephrotoxicity, 14; neutropenic infection, 2 and pulmonary toxicity, 1. Independent risk factors for G3-5 systemic toxicity after multivariate analysis were a dose of CDDP for HIPEC of 240 mg or more (OR 2.78, CI 95% 1.20-6.45) and CDDP+Dx schedule for HIPEC (OR 2.36, CI 95% 1.02-5.45). PRM was 1.2%.CRS+HIPEC presented acceptable systemic toxicity and PRM rates. Independent risk factors for systemic toxicity were the CDDP+Dx schedule and CDDP dose for HIPEC. |
| Databáze: | OpenAIRE |
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