Intra-Peritoneal Chemo-Hyperthermia (CHIP): a new therapy in the treatment of the peritoneal seedings. Preliminary report.

After an experimental study in dogs, authors report a new therapeutic device for peritoneal seedings (Intra-Peritoneal Chemo-Hyperthermia) and their preliminary results in five patients. They observed no mortality and no morbidity with this protocol using Mitomycin as antimitotic and hyperthermia as sensibilisation agent. This new technique means important technological and time investment but preliminary results appear to be encouraging and authors intend to standardize the present apparatus in order to go on using this device and obtain more experience.

Quimio-hipertermia intraperitoneal con mitimicina C en cáncer avanzado con carcinomatosis peritoneal: primera experiencia / Intraperitoneal chemo-hypertermia with mytomicina C

La quimiohipertermia intraperitoneal (ITCH) con Mitomicina C (MMC) fue usada en el tratamiento de 7 pacientes con cancer gastrointestinal avanzado y carcinomatosis peritoneal. La reseccion primaria del tumor fue posible en 2 casos. La IPCH se realizo despues del cierre de la pared abdominal durante 90 y 120 minutos bajo anestesia general con previa hipotermia a 32º Celsius, a traves de un circuito cerrado formado con 3 drenajes de silicona intraperitoneal; se uso concentracion de 10 mg/L de MMC en 6000 mL de liquido precalentado a 46-49º Celsius. No observamos ni mortalidad ni morbilidad. Otros autores han informado efectos biologicos secundarios ligeros y temporales; no hubo celulas malignas en el liquido ascitico despues de la IPCH. Igualmente observamos en 6 pacientes un incremento en el indice de Karnofsky, 3 y 7 meses despues de la IPCH. Estos resultados nos permiten confirmar que la IPCH con MMC es un metodo sin riesgo, que puede ser usado en el tratamiento del cancer gastrointestinal avanzado con carcinomatosis peritoneal.

Experience of three years with intra-operative radiation therapy using the Lyon intra-operative device.

Since November 1985, we have performed 54 Intra-Operative Radiation Therapy (IORT) interventions, essentially in gastric cancer (20 patients) and in pancreatic cancer (22 patients). Mortality, morbidity, and average of survival rates were compared with a non-randomized control group: mortality and morbidity rates were similar in the two groups, with or without IORT. The follow-up period was too short for any valid conclusions about IORT in gastric cancer to be reached. However, in the case of unresectable pancreatic cancer, a significant difference was observed in survival rates when patients were treated by surgery alone or surgery and IORT (4.7 months), and when they were treated by surgery, IORT and external postoperative radiotherapy (8.9 months) (p less than 0.05). The study also examined the relief of abdominal and back pain in patients with unresectable pancreatic cancer: in our experience, survival was longer and more comfortable for patients treated with surgery and IORT. In conclusion, it appears that today IORT is without doubt a good palliative treatment for unresectable pancreatic cancer, but more experience is needed before a conclusion can be reached regarding resectable pancreatic cancer and gastric cancer.

[A new technic of intraoperative radiotherapy: the Lyon intraoperative device]. / Une nouvelle technique de radiothérapie intra-opératoire: le "Lyon intra operative device".

Since November 1985, we performed Intra Operative Radiation Therapy in 53 cases, essentially in gastric cancer (20 patients) and in pancreatic cancer (22 patients). Mortality and morbidity were not increased by the use of Intra Operative Radiation Therapy. Our follow up is too short to get any valid conclusions about IORT in gastric cancer. However, for unresectable pancreatic cancer, we observed an improvement of the survey when patients were treated by "Surgery, IORT and External post operative radiotherapy". We also studied the relief of abdominal and back pain of unresectable pancreatic cancer: in our experience, the survey was longer and more confortable for patients treated with surgery and IORT. In conclusion it appears that today IORT is surely a good palliative treatment for unresectable pancreatic cancer, and longer experience is needed to conclude for resectable pancreatic cancer and for gastric cancer.