Pharmacokinetics
Intraperitoneal (IP) delivery of chemotherapy offers a potential therapeutic advantage over systemic chemotherapy by producing high regional concentrations of drug while simultaneously minimizing systemic toxicities. The selection of agents for perioperative intra-peritoneal chemotherapy is based on the drug's ability to produce a cytotoxic effect over a short time period and pharmacological data.
Mitomycin C, doxorubicin and cisplatin have a slow clearance from the peritoneal cavity. Pharmacokinetic studies of intraoperative intraperitoneal chemotherapy report an absorption of 75- 90% of the mitomycin C and cisplatin within the first hour.
Despite the greatly enhanced drug cytotoxicity because of high concentrations and heat synergy the technique is effective only in treating small volume peritoneal disease.
| cytostatic drug | molecular weight | AUC Ratio systemic vs. ip. |
| 5-Fluorouracil | 130 | 1 : 250 |
| Irinotecan | 677 | 1 : 18 |
| Oxaliplatin | 397 | 1 : 25 |
| Cisplatin | 300 | 1 : 20 |
| Mitomycin | 334 | 1 : 75 |
| Doxorubicin | 544 | 1 : 500 |
| Mitoxantron | 445 | 1 : 640 |
| Paclitaxel | 854 | 1 : 1000 |