Calculating the dose of cisplatin that is actually utilized in hyperthermic intraperitoneal chemotherapy among ovarian cancer patients.

BACKGROUND: Hyperthermic intraperitoneal chemotherapy (HIPEC) is an important treatment for ovarian cancer. A certain portion of cisplatin exits the body via the perfusate at the end of HIPEC, so full-dose utilization cannot be achieved. Herein, we sought to explore how much cisplatin is actually utilized and its prognostic influence. METHODS: Cisplatin (70 mg/m2) was given at 43 °C for 90 min. The actually utilized dose (AD) of cisplatin was calculated using the following formula: AD (mg) = total dose (TD) (mg)-losing dose (LD) (mg); LD = volume (ml) of the perfusate (VPretained) that was retained in the HIPEC treatment system at the end of HIPEC * concentration of cisplatin in the perfusate (mg/ml). RESULT: Sixty-two ovarian cancer patients were included. The median TD, median LD and median AD were 95 mg, 20.7 mg and 75.8 mg, respectively. The utility rate of cisplatin (AD/TD ratio) was 79.2%. On simple linear regression analysis, the TD and VPretained were found to significantly predict the AD. Based on these two factors, multiple linear regression analysis was conducted, and a significant regression equation was formulated [F (2, 59) = 71.419, P < 0.0001]: predicted AD (mg) = 30.079 + 0.667 TD (mg) - 0.010 VPretained (ml) (adjusted R2 = 0.698). In Cox regression analysis, AD was not noted to be associated with progression free survival or overall survival. CONCLUSION: For ovarian cancer patients who receive cisplatin for HIPEC at 43 °C, the AD of cisplatin can be predicted using a regression equation and it has no prognostic impact.

Feasibility and safety of neoadjuvant laparoscopic hyperthermic intraperitoneal chemotherapy in patients with advanced stage ovarian cancer: a single-center experience.

OBJECTIVES: For patients with advanced ovarian cancer, neoadjuvant chemotherapy (NACT) can significantly increase the rate of optimal cytoreduction. However, this does not translate into a survival benefit. The aim of this study was to investigate the feasibility and effect of neoadjuvant laparoscopic hyperthermic intraperitoneal chemotherapy (NLHIPEC). METHODS: Between March 2016 and February 2018, 14 patients with advanced ovarian cancer who were not candidates for optimal cytoreduction via primary debulking surgery (PDS) received NLHIPEC. Their clinical data were retrospectively analyzed. RESULTS: No patients experienced intraoperative complications during NLHIPEC. Grade 3 adverse events (AEs) were noted in two (14.3%) patients, and all patients received planned NACT without dose delay or dose reduction. Following NACT, CA125 levels <35 U/mL and <20 U/mL were observed in six (42.9%) patients and five (35.7%) patients, respectively. All patients underwent interval debulking surgery (IDS) after the last NACT cycle. After IDS, R0 resection was achieved in 10 (71.4%) patients without intraoperative injury, and one (7.1%) patient developed a grade 3 AE. During a median follow-up time of 16 months, no patients died of disease, and the median progression-free survival (PFS) was not achieved. Progression was noted in six (42.9%) patients (range, 9-21 months). CONCLUSIONS: NLHIPEC appears to be a feasible option for ovarian cancer patients who have a low likelihood of achieving optimal cytoreduction during PDS.

[Root growth characteristics and competitive effects of Ageratina adenophora and four functional type herbaceous plants].

A field experiment was conducted to explore the root competitive effects of Ageratina adenophora and Setaria sphacelata, S. yunnanensis, Eupatorium fortunei, Chenopodium serotinum in monoculture and mixture, and the relative competitive abilities were evaluated. The results showed that the root length, superficial area and volume of A. adenophora in mixture were lower than in monoculture, but those of S. sphacelata were higher in mixture than in monoculture. The biomass of A. adenophora in mixture decreased by 77.1% and that of S. sphacelata increased by 80.4% compared with those in monoculture. The relative yield and competitive balance index of S. sphacelata were significantly higher than those of A. adenophora, and the relative yield was about 1.0, suggesting that the underground competitive ability of S. sphacelata was higher than A. adenophora. The root morphology of S. yunnanensis in monoculture and mixture was higher than those of A. adenophora, but the root morphology of two species in mixture was lower than in monoculture. The biomass of A. adenophora and S. yunnanensis in mixture decreased by 45.3% and 22.8% compared with those in monoculture, respectively. Competition effect parameters showed that A. adenophora was a mutual antagonism with S. yunnanensis. The root morphology of E. fortunei and A. adenophora in mixture showed no significant difference compared with that in monoculture. The biomass of A. adenophora and E. fortunei was lower than that in monoculture, respectively. Competition effect parameters showed that A. adenophora was a superior competitor. In the mixture of A. adenophora and C. serotinum, the root morphology parameters and competitive ability of A. adenophora were superior to those of C. serotinum. Above all, S. sphacelata is a preference plant material to control the A. adenophorum invasion and recover biodiversity in A. adenophorum invasion fields.