Oncology - specialised tumor therapy

optimized treatment of peritonealcarcinoses
surgical oncology - regional chemotherapy

Intraperitoneal Chemotherapy

Principles of intraperitoneal chemotherapy

  1. dose - response relationship
    Intraperitoneal application of drugs such as cytostatic agents will lead to high local drug concentrations in the abdominal cavity. Due to the existence of a dose - response - relationship for cytostatic agants such increase in local drug concentrations will lead to an increase in response rates.
  2. peritoneal plasma barrier
    Large molecular weight compounds when instilled into the peritoneal cavity are sequestered at that site for long periods. The physiologic barrier to the release of intraperitoneal drugs is called the peritoneal space to plasma barrier. This means that the exposure of peritoneal surfaces to pharmacologically active molecules can be increased considerably by giving the drugs via the intraperitoneal as opposed to intravenous route.

Benefits of intraoperative chemotherapy

Intraoperative chemotherapy allows a uniform distribution of drugs to all surfaces of the abdomen and pelvis.
Nausea and vomiting are avoided because the patient is under general anesthesia

Limits of intraperitoneal chemotherapy

Intracavitary instillation allows very limited penetration of drug into tumor nodules. Only the outermost layer (~1 mm) of a cancer nodule is penetrated by the chemotherapy. This means that only minute tumor nodules can be definitively treated. Microscopic residual disease is the ideal target for intraperitoneal chemotherapy protocols.

A second cause for limited success with intraperitoneal chemotherapy is a non-uniform drug distribution. A majority of patients treated by drug instillation into the abdomen or pelvis had prior surgery, which invariably causes scarring between peritoneal surfaces. The adhesions create multiple barriers to the free access of fluid. Although the instillation of a large volume of fluid will partially overcome the problems created by adhesions, some surface areas will have no access to chemotherapy. Limited access from adhesions was impossible to predict and increased with repeated instillations of chemotherapy solutions.

Only an intraoperative use of intraperitoneal chemotherapy can overcome the problem of non-uniform distribution.

Should you have any questions about the contents of this website or need more information as a patient, you may also get in contact with us. To correctly, gratuitous answer your queries all current documents, such as laboratory results, surgical reports and CT or MR images are required.
For submitting your request you can use the contact form

Herwart Müller, M.D.

Head of the Department of General Surgery in the Wertheim Hospital
E-Mail: Herwart.Mueller@swmbrk.de
Secretary: Anneliese Holzhäuser, Birgit Rauer
E-Mail: anneliese.holzhaeuser@swmbrk.de, birgit.rauer@swmbrk.de
Phone: +49 9342/303-5002
Fax:         +49 9342/303-5001
Reception: +49 9342/303-0
Rotkreuzklinik Wertheim gGmbH, Rotkreuzstr. 2
97877 Wertheim

Rotkreuzklinik Wertheim gGmbH

Abteilung für Allgemeinchirurgie
Rotkreuzstr. 2
97877 Wertheim / Bayern
+49 9342 / 303-5002