Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/s10434-007-9571-9
Annals of Surgical Oncology 15:339-344 (2008)
© 2008 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gesson-Paute, A.
Right arrow Articles by Querleu, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gesson-Paute, A.
Right arrow Articles by Querleu, D.

Original Article

Pharmacokinetics of Oxaliplatin During Open Versus Laparoscopically Assisted Heated Intraoperative Intraperitoneal Chemotherapy (HIPEC): An Experimental Study

Amélie Gesson-Paute, MD1, Gwenael Ferron, MD1,3, Fabienne Thomas, MD2,3, Emanuelle Cohen de Lara, MD2,3, Etienne Chatelut, MD, PhD2,3 and Denis Querleu, MD1,3

1 Department of Surgical Oncology, Institut Claudius Regaud, 20-24 Rue du Pont Pierre, 31052 Toulouse Cedex, France
2 EA3035, Institut Claudius Regaud, 20-24 Rue du Pont Pierre, 31052 Toulouse Cedex, France
3 Paul Sabatier University, University of Toulouse, Toulouse, France

Correspondence: Address correspondence and reprint requests to: Gwenael Ferron, MD; E-mail: ferron.gwenael{at}claudiusregaud.fr

Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is being evaluated for patients with minimal residual or no residual disease after primary surgery and chemotherapy for stage III ovarian carcinoma. The technical feasibility of the laparoscopic approach for HIPEC has been demonstrated in a previous study. An experimental study on the porcine model was carried out to compare oxaliplatin pharmacokinetics during a laparoscopic-assisted procedure versus the coliseum technique for HIPEC.

Methods: Adult pigs received an HIPEC procedure that was based on 460 mg/m2 of oxaliplatin over 30 minutes with a perfusate heated at 41°C to 43°C. The HIPEC drains were placed in the upper and lower quadrants of the abdomen. Peritoneal fluid and blood samples were collected every 10 minutes during the procedure, and the pharmacokinetics of oxaliplatin was studied.

Results: Two groups of 10 adult pigs were studied. All the procedures were successfully completed with an adequate intra-abdominal temperature and distribution. No major technical problems were encountered. At the end of the HIPEC, 41.5% of the molecule was absorbed in the laparoscopic group compared with 33.4% in the laparotomy group (P = .0543). Peritoneal oxaliplatin half-life (T1/2) was significantly faster in the laparoscopic procedure (median, 37.5 vs. 59.3 minutes, P = .02). The area under the curve ratio of peritoneal to plasma reflects a more important oxaliplatin crossing through the peritoneal barrier in the laparoscopic procedure (ratio, 16.4 in the closed procedure vs. 28.1 in the open one; P = .03).

Conclusions: This study confirms the technical feasibility and reliability of the laparoscopic approach for HIPEC, and it extends knowledge concerning peritoneal drug absorption. Oxaliplatin absorption is far higher with laparoscopy in terms of time course in peritoneal perfusion. Clinical application in selected patients may be expected after further experimental investigation designed to define the adequate drug dosage.

Key Words: Hyperthermia • Intraperitoneal chemotherapy • laparoscopy • oxaliplatin • pharmacokinetics






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the Society of Surgical Oncology.