MedStar Authors catalog › Details for: Body surface area-based vs concentration-based perioperative intraperitoneal chemotherapy after optimal cytoreductive surgery in colorectal peritoneal surface malignancy treatment: COBOX trial.
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Body surface area-based vs concentration-based perioperative intraperitoneal chemotherapy after optimal cytoreductive surgery in colorectal peritoneal surface malignancy treatment: COBOX trial.

by Sugarbaker, Paul H.
Citation: Journal of Surgical Oncology. 119(7):999-1010, 2019 Jun..Journal: Journal of surgical oncology.Published: ; 2019ISSN: 0022-4790.Full author list: Lemoine L; Thijssen E; Carleer R; Geboers K; Sugarbaker P; van der Speeten K.UI/PMID: 30838646.Subject(s): Aged | Ascitic Fluid/me [Metabolism] | Colorectal Neoplasms/dt [Drug Therapy] | Colorectal Neoplasms/me [Metabolism] | Colorectal Neoplasms/su [Surgery] | *Colorectal Neoplasms/th [Therapy] | Cytoreduction Surgical Procedures/mt [Methods] | Female | Fluorouracil/ad [Administration & Dosage] | Humans | *Hyperthermia, Induced/mt [Methods] | Leucovorin/ad [Administration & Dosage] | Male | Middle Aged | *Oxaliplatin/ad [Administration & Dosage] | Oxaliplatin/bl [Blood] | Oxaliplatin/pk [Pharmacokinetics] | Oxaliplatin/ur [Urine] | Perioperative Care/mt [Methods] | Pilot Projects | Quality of LifeInstitution(s): Washington Cancer InstituteActivity type: Journal Article.Medline article type(s): Clinical Trial, Phase III | Journal Article | Randomized Controlled TrialOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1002/jso.25437 (Click here) ORCID: Sugarbaker, Paul http://orcid.org/0000-0002-2431-7366 (Click here) Abbreviated citation: J Surg Oncol. 119(7):999-1010, 2019 Jun.Abstract: BACKGROUND AND OBJECTIVES: Cytoreductive 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.Abstract: METHODS: Body surface area (BSA)- and concentration-based HIPEC protocols were clinically and pharmacologically evaluated in a randomized phase III clinical pilot trial. Oxaliplatin dose was 460 mg/m <sup>2</sup> (BSA-based) in 2 L/m <sup>2</sup> 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.Abstract: RESULTS: Thirty-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.Abstract: CONCLUSION: Concentration-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.Abstract: Copyright (c) 2019 Wiley Periodicals, Inc.

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