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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/29535

Title: Body surface area-based vs concentration-based perioperative intraperitoneal chemotherapy after optimal cytoreductive surgery in colorectal peritoneal surface malignancy treatment: COBOX trial
Authors: Lemoine, Lieselotte
Thijssen, Elsy
Carleer, Robert
Geboers, Karlien
Sugarbaker, Paul
van der Speeten, Kurt
Issue Date: 2019
Publisher: WILEY
Citation: JOURNAL OF SURGICAL ONCOLOGY, 119(7), p. 999-1010
Abstract: Background and ObjectivesCytoreductive surgery (CRS) and hyperthermic intraperitoneal perioperative chemotherapy (HIPEC) are the standard of care for patients diagnosed with colorectal peritoneal surface malignancy (PSM). Despite a clearly defined standardization of CRS, a large variety of HIPEC modalities are still used in clinical practice. MethodsBody surface area (BSA)- and concentration-based HIPEC protocols were clinically and pharmacologically evaluated in a randomized phase III clinical pilot trial. Oxaliplatin dose was 460mg/m (2) (BSA-based) in 2L/m (2) carrier solution (concentration-based). Platinum quantification was performed using a validated inductively coupled plasma mass spectrometry method. Three-month morbidity, mortality, and health-related quality of life (HRQOL) were assessed. ResultsThirty-one patients were randomized to either BSA- or concentration-based HIPEC. Toxicity and efficacy were higher (P<0.001) in patients receiving concentration-based HIPEC. There was no difference in pharmacologic advantage between the two groups. A higher drug concentration in the tumor nodule at the end of HIPEC was found in the HIPEC-concentration group. There was no difference in major morbidity and mortality between the treatment groups. HRQOL was decreased 3 months postoperatively in the HIPEC-concentration group. ConclusionConcentration-based chemotherapy delivers the drug in the most standardized way to the tumor nodule, resulting in increasing drug concentrations in the tumor nodule without increasing major morbidity.
Notes: [Lemoine, Lieselotte; Geboers, Karlien; van der Speeten, Kurt] Hasselt Univ, Dept Med & Life Sci, Hasselt, Belgium. [Lemoine, Lieselotte; van der Speeten, Kurt] Ziekenhuis Oost Limburg, Dept Surg Oncol, Campus Sint Jan,Schiepse Bos 6, B-3600 Genk, Belgium. [Thijssen, Elsy; Carleer, Robert] Hasselt Univ, Inst Mat Res, Appl & Analyt Chem, Diepenbeek, Belgium. [Sugarbaker, Paul] MedStar Washington Hosp Ctr, Ctr Gastrointestinal Malignancies, Washington, DC USA.
URI: http://hdl.handle.net/1942/29535
DOI: 10.1002/jso.25437
ISI #: 000476938900024
ISSN: 0022-4790
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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