INTRAPERITONEAL CISPLATIN AND ETOPOSIDE IN PERITONEAL MESOTHELIOMA - FAVORABLE OUTCOME WITH A MULTIMODALITY APPROACH

Ten patients with histologically documented peritoneal mesothelioma we re treated with intraperitoneal cisplatin 200 mg/m2, Sodium thiosulfat e rescue and etoposide 65 - 290 mg/m2 every 4 weeks for a maximum of s ix cycles. All had epithelial or mixed epithelial-fibrous histology. T oxicity was tolerable, with 50% sustaining grade 3 or 4 granulocytopen ia. There was one episode of neutropenic fever. Grade 2 peripheral neu ropathy occurred in one patient, grade 1 in five patients. Complete re mission occurred in one of five patients with measurable disease. Medi an survival for patients whose tumors were surgically debulked to <2 c m residua prior to treatment was 22 months, while it was 5 months for those with measurable, surgically inaccessible disease (P = 0.0731 by Cox regression proportional hazard model). These data suggest that pat ients who present with resectable disease may benefit from an aggressi ve adjuvant approach. This possibility warrants prospective testing in a randomized clinical trial.