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IPHC / HYPEC = chemo hyperthermia in metastatic peritoneal cancer (colonrectalcancer) adenocarcinoomtype gives the results gained significantly longer survival, said study in 77 patients.

dated February 26, 2004: Source: Reuters

Intraperitoneal chemotherapy with the addition of hyperthermia in (colorectal) cancer with peritoneal metastases showing excellent results.


Patients with non appendiceale (appendix not affected, my free translation) invasive peritoneal cancer (colorectal) with cytoreductive surgery (surgery with additional chemotherapy with the aim of tumor reduction and not curative intended) plus intraperitoneal hyperthermic chemotherapy (IPHC) are treated survived longer than untreated patients, according to results of a retrospective study of 77 patients.

After three years, the median overall survival was 25%, and after five years, it was 17%, the investigators report in the February issue of The Annals of Surgical Oncology (Ann Surg Oncol 2004, 11:178-186). Without treatment, the median survival for patients with peritoneal cancer (colonrectalcancer) 3 to 6 months.

The findings indicate that this treatment results for selected colorectal cancer patients who experience a metastasis in the abdomen, the quality of life and life can improve especially if complete surgical removal of the cancer can be achieved, said lead author Dr.. Perry Shen of Wake Forest University, Winston-Salem, North Carolina

Surgery plus IPHC is a proven effective treatment for peritoneal cancer (colorectal cancer) cancer that spreads toward appendix, and a few other rare forms of cancer, said Dr.. Shen.

"In many cases you can not remove the entire tumor," Dr. Shen continued. "But when so much of the large tumor is removed, we observed a median overall survival of 28 months." Of the 77 patients, surgeons were able to complete resection in 37 patients (48%), during procedures in patients in the period 1991 to 2002.

Dr. Shen said that studies in animals indicate that IPHC in surrounding tissue in a radius of approximately 5 millimeters penetrates and destroys potential cancer cells from the tumor site have spread. The administration of IPHC after the resection is completed allows higher concentrations of the drug to go directly to the place of the primary tumor while minimizing adverse events are systemic toxicity.
If the normal standard chemotherapy is administered, without hyperthermia , the drug has not been successful at similar concentrations to reach the tumors, said Dr.. Shen.

Other experimental evidence suggests that tumor cells are more sensitive to heat than normal tissue. Consequently, the tumor has less resistance to chemotherapy when the temperature of the drug is increased.

Nearly 75% of patients had received chemotherapy prior to surgery and IPHC treatment. The average age of participants was 54 years old. Of the total procedures, 74 were treated for a primary tumor in the colon and 3 in the rectum. All patients in the study had a histological diagnosis of adenocarcinoma.

Morbidity and mortality of 'Perioperative' (I do not know what this means: mortality nav or prior to surgery?) Were 30% and 12%. Approximately 19% of patients experienced hematologic (anemia, etc.) side effects.

The group of Dr. Shen's notes that future research using molecular markers may include means to determine which patients benefit most from surgery plus IPHC may have.

The above translation of the following press release was circulated by Reuters of 13 February 2004.

Source: Reuters

Ann Surg Oncol 2004, 11:178-186.
Intraperitoneal hyperthermia Chemotherapy Shows Promise for Colorectal Cancer

NEW YORK (Reuters Health) Feb 13 - Patients with non-invasive appendiceal colorectal cancer who are Treated with cytoreductive surgery plus intraperitoneal hyperthermia chemotherapy (IPHC) survived longer Than untreated patient, According To the results of a retrospective study of 77 patients.

After three years, the median overall survival rate was 25%, and after five years, it was 17%, the investigators report in the February issue of the Annals of Surgical Oncology. Without treatment, the average survival for Patient with Peritoneal carcinomatosis is 3 to 6 months.

The Findings Indicating That this can-ImproveGhana treatment outcomes for selected colorectal cancer patients who experience a spread of the cancer Into the abdomen,Especially if a complete resection of all the cancer Can Be Achieved, lead author Dr. Perry Shen of Wake Forest University, Winston-Salem, North Carolina, Told Reuters Health.

Surgery plus IPHC HAS proven to be an effective treatment for colorectal cancer That spreads to the appendix, as well as a few rare cancers Other, Dr. Shen said.

"In many cases you can not remove the Entire tumor," Dr.. Shen continued. "But if you remove as much as Possible of the bulky tumor, we observed a median overall survival of 28 months." Of the 77 patients, the surgeons Were Able to Achieve a complete resection in 37 (48%) procedures consistently Between 1991 and 2002.

Dr. Shen said animal studies Indicating That IPHC penetrates surrounding 'tissue in a radius of about 5 millimeters, That Have Potentially Eradicate cancer cells migrated away from the tumor site. Delivering IPHC after the resection is completed Allows Higher Concentrations of the drug to go directly to the site of the tumor while Minimizing systemic toxicity. If chemotherapy is delivered normally, it fails to Achieve Similar Concentrations at the tumor site, Dr.. Shen said.

Other experimental evidence indicates tumor tissue is more sensitive to heat Than normal tissue. Axis a result, the tumor resistance to chemotherapy less HAS When The temperature of the drug raises.

Nearly 75% of the patient experienced Received chemotherapy prior to the surgery and IPHC treatment. The median age of the Participants was 54 years old. Of the total procedures, 74 Were Conducted to resect a primary site in the colon and rectum 3. All the patients in the study had a histological diagnosis of adenocarcinoma.

Perioperative morbidity and mortality Were 30% and 12%, respectively. About 19% of the Patients Experienced hematological toxicity.

Dr. Shen's group notes That May future research include the use of molecular markers to Which Patients Would qualification must derive benefit from the surgery plus IPHC.

Ann Surg Oncol2004, 11:178-186.