By Maurie Markman (auth.), Paul H. Sugarbaker M.D., F.A.C.S. (eds.)
Peritoneal carcinomatosis dominates the scientific photo of many sufferers with gastrointestinal, gynecological and urological cancers. for plenty of of them its dev astating results give a contribution on to their loss of life. such a lot clinicians contemplate peritoneal carcinomatosis an incurable metastatic sickness and provides palliative therapy, re stricted to restricted surgical procedure and systemic chemotherapy. opposite to this view, Paul Sugarbaker and his collegues base their strategy at the idea that peritoneal carcinomatosis represents local tumor unfold, comparable in its effect on therapy and diagnosis to that of lymph node metastases in different malignancies. this idea emphasises the price of local tumor keep an eye on, as a in all probability healing degree. during this ebook the mix of competitive cytoreduction and intraperitoneal chemotherapy to regulate peritoneal carcinomatosis is broadly explored. uncomplicated to this procedure is the remark that the majority melanoma cells express simply relative resistence opposed to quite often on hand medicines, which are triumph over by way of a enough bring up of drug concentrations in tumor tissue. After intraperitoneal supply, medicinal drugs will succeed in excessive tissue concentrations within the superficial few phone layers, whereas plasma concentrations will stay less than poisonous degrees. sufferers with in simple terms restricted residual tumor on the peritoneal floor after cytoreduction may perhaps for that reason take advantage of intraperitoneal chemotherapy.
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Example text
Hyperthermic administrations used 50 mg/m2 of drug in 3 I of dialysis fluid, cycled in and out of the abdominal/pelvic cavity for 2 hours. Data were analyzed for statistical significance with Student's t-test. ND = not done; NS = not statistically significant. ; AUC = area under the curve. studied in eight patients. There were some differences in the study design in these two groups of patients. The normothermic administration used a single instillation of drug in 2 I of dialysis fluid. The hyperthermic administrations were in 3 1 of dialysis fluid, and the fluid was lavaged in and out of the abdominal cavity for 2 hours with continuous agitation of the abdomen.
7. Markman M. Intraperitoneal antineoplastik agents for tumors principally confined to the peritoneal cavity. Cancer Treat Rev 1986;13:219-242. 8. Runhaar EA, van Oosterom AT, De Bruijn EA, ten Bokkel Huinink WW. Intraperitoneal chemotherapy in ovarian carcinoma. Netherlands J Med 1987;30:94-103. 9. Sugarbaker PH. Intraperitoneal5-FU in patients with colon or rectal cancer. Contrib OncoI1988;29:84109. 10. Sugarbaker PH, Cunliffe W, Belliveau JF, De Bruijn EA, Graves T, Mullins R, et al. Rationale for perioperative intraperitoneal chemotherapy as a surgical adjuvant for gastrointestinal malignancy.
The temperatures recorded in a single patient at three different anatomic sites and the heat exchanger are shown in figure 3. These data represent temperature profiles that were typical of every patient in the study. As may be expected, the heat exchanger temperature and the maximum temperatures recorded immediately adjacent to the Tenckhoff catheter are quite similar. The heat rapidly dissipates within the peritoneal cavity as high blood flow in viscera transmits the heat to other portions of the body.