Heated Chemotherapy for Abdominal Cancer Improves Survival

Combining heated chemotherapy with surgery can improve survival rates and quality of life in patients with cancer of the abdominal cavity that has spread from the colon, according to a study in the February 2004 issue of Annals of Surgical Oncology.

The study involved 77 patients with peritoneal disease that had spread from colorectal cancer. Traditionally, patients with this condition, called peritoneal carcinomatosis, survive only three to six months without treatment. All patients had surgery to remove as much of the tumor and surrounding cancerous tissue as possible, followed afterward with a treatment called intraperitoneal hyperthermic chemotherapy (IPHC). This cools the patient's core temperature to just over 93oF. Immediately after surgery, catheters were placed in the abdomen to deliver the chemotherapy directly into the abdominal cavity. The chemotherapy agent, heated to a maximum temperature of 105oF, was delivered through the catheters, while the abdomen was gently massaged to improve drug distribution.

Patients in the study had a median overall survival of 16 months, with 17% surviving five years or more. Experimental evidence suggests that tumor tissue is more sensitive to heat than normal tissue and has less resistance to chemotherapy when the temperature of the drug is raised.

"This study, combined with reports from other institutions, indicates that selected patients can achieve long-term survival with complete removal of peritoneal disease from colorectal cancer, which is the second leading cause of cancer death in the United States,” said lead author Perry Chen, M.D., assistant professor of surgical oncology at Wake Forest University Baptist Medical Center (NC, USA).




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