The Role of Intraperitoneal Intraoperative Chemotherapy with Paclitaxel in the Surgical Treatment of Peritoneal Carcinomatosis from Ovarian Cancer—Hyperthermia versus Normothermia: A Randomized Controlled Trial

Áreas de investigación:

• Sin categoría

Año:

2021

Tipo de publicación:

Artículo

Palabras clave:

Ovarian cancer, Peritoneal carcinomatosis, Intraperitoneal chemotherapy

Autores:

• Casado-Adam, Angela
• Rodriguez-Ortiz, Lidia
• Rufian-Peña, Sebastian
• Muñoz-Casares, Cristobal
• Caro-Cuenca, Teresa
• Ortega-Salas, Rosa
• Fernandez-Peralbo, Maria Auxiliadora
• Luque-de-Castro, Maria Dolores
• Sanchez-Hidalgo, Juan M.
• Hervás-Martínez, César
• Romero-Ruiz, Antonio
• Briceño, Javier
• Arjona-Sánchez, Álvaro

Journal:

Journal of Clinical Medicine

Volumen:

11

Páginas:

1-14

Mes:

September

ISSN:

2077-0383

BibTex:

@article{Hyperthermia_vs_Normothermia_2021, author = "Angela Casado-Adam and Lidia Rodriguez-Ortiz and Sebastian Rufian-Pe{\~n}a and Cristobal Mu{\~n}oz-Casares and Teresa Caro-Cuenca and Rosa Ortega-Salas and Maria Auxiliadora Fernandez-Peralbo and Maria Dolores Luque-de-Castro and Juan M. Sanchez-Hidalgo and C{\'e}sar Herv{\'a}s-Mart{\'i}nez and Antonio Romero-Ruiz and Javier Brice{\~n}o and {\'A}lvaro Arjona-S{\'a}nchez", abstract = "Background: The treatment of ovarian carcinomatosis with cytoreductive surgery and HIPEC is still controversial. The effect and pharmacokinetics of the chemotherapeutics used (espe-cially taxanes) are currently under consideration. Methods: A phase II, simple blind and randomized controlled trial (NTC02739698) was performed. The trial included 32 patients with primary or recurrent ovarian carcinomatosis undergoing cytoreductive surgery (CRS) and intraoperative intraperitoneal chemotherapy with paclitaxel (PTX): 16 in hyperthermic (42–43 ◦C) and 16 in normothermic (37 ◦C) conditions. Tissue, serum and plasma samples were taken in every patient before and after intraperitoneal chemotherapy to measure the concentration of PTX. To analyze the immunohistochemical profile of p53, p27, p21, ki67, PCNA and caspase-3 and the pathological response, a scale of intensity and percentage of expression and a grouped Miller and Payne system were used, respectively. Perioperative characteristics and morbi-mortality were also analyzed. Results: The main characteristics of patients, surgical morbidity, hemotoxicity and nephrotoxicity were similar in both groups. The concentration of paclitaxel in the tissue was higher than that observed in plasma and serum, although no statistically significant differences were found between the two groups. No statistically significant association regarding pathological response and apoptosis (caspase-3) between both groups was proved. There were no statistically significant differences between the normothermic and the hyperthermic group for pathological response and apoptosis. Conclusions: The use of intraperitoneal PTX has proven adequate pharmacokinetics with reduction of cell cycle and proliferation markers globally without finding statistically significant differences between its administration under hyperthermia versus normothermia conditions.", awards = "JCR(2021): 4.964, Position: 54/172 (Q2) Category: MEDICINE, GENERAL {\&}amp; INTERNAL", comments = "JCR(2021): 4.964, Position: 54/172 (Q2) Category: MEDICINE, GENERAL {\&}amp; INTERNAL", doi = "10.3390/jcm11195785", issn = "2077-0383", journal = "Journal of Clinical Medicine", keywords = "Ovarian cancer, Peritoneal carcinomatosis, Intraperitoneal chemotherapy", month = "September", note = "JCR(2021): 4.964, Position: 54/172 (Q2) Category: MEDICINE, GENERAL {\&}amp; INTERNAL", pages = "1-14", title = "{T}he {R}ole of {I}ntraperitoneal {I}ntraoperative {C}hemotherapy with {P}aclitaxel in the {S}urgical {T}reatment of {P}eritoneal {C}arcinomatosis from {O}varian {C}ancer—{H}yperthermia versus {N}ormothermia: {A} {R}andomized {C}ontrolled {T}ri", url = "doi.org/10.3390/jcm11195785", volume = "11", year = "2021", }

Nota:

JCR(2021): 4.964, Position: 54/172 (Q2) Category: MEDICINE, GENERAL & INTERNAL

Abstract:

Background: The treatment of ovarian carcinomatosis with cytoreductive surgery and HIPEC is still controversial. The effect and pharmacokinetics of the chemotherapeutics used (espe-cially taxanes) are currently under consideration. Methods: A phase II, simple blind and randomized controlled trial (NTC02739698) was performed. The trial included 32 patients with primary or recurrent ovarian carcinomatosis undergoing cytoreductive surgery (CRS) and intraoperative intraperitoneal chemotherapy with paclitaxel (PTX): 16 in hyperthermic (42–43 ◦C) and 16 in normothermic (37 ◦C) conditions. Tissue, serum and plasma samples were taken in every patient before and after intraperitoneal chemotherapy to measure the concentration of PTX. To analyze the immunohistochemical profile of p53, p27, p21, ki67, PCNA and caspase-3 and the pathological response, a scale of intensity and percentage of expression and a grouped Miller and Payne system were used, respectively. Perioperative characteristics and morbi-mortality were also analyzed. Results: The main characteristics of patients, surgical morbidity, hemotoxicity and nephrotoxicity were similar in both groups. The concentration of paclitaxel in the tissue was higher than that observed in plasma and serum, although no statistically significant differences were found between the two groups. No statistically significant association regarding pathological response and apoptosis (caspase-3) between both groups was proved. There were no statistically significant differences between the normothermic and the hyperthermic group for pathological response and apoptosis. Conclusions: The use of intraperitoneal PTX has proven adequate pharmacokinetics with reduction of cell cycle and proliferation markers globally without finding statistically significant differences between its administration under hyperthermia versus normothermia conditions.

Comentarios:

JCR(2021): 4.964, Position: 54/172 (Q2) Category: MEDICINE, GENERAL & INTERNAL