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International Journal of Surgical Oncology
Volume 2011 (2011), Article ID 185092, 9 pages
http://dx.doi.org/10.1155/2011/185092
Research Article

Pharmacokinetic Study of Perioperative Intravenous Ifosfamide

1Department of Surgical Oncology, Hospital East-Limburg, 3600 Genk, Belgium
2Washington Cancer Institute, Washington Hospital Center, Washington, DC 20010, USA
3Division of Surgical Sciences, Department of Surgery, Uppsala University Hospital, 75185 Uppsala, Sweden

Received 17 March 2011; Revised 27 June 2011; Accepted 13 July 2011

Academic Editor: Wai Lun Law

Copyright © 2011 Kurt Van der Speeten et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The use of cancer chemotherapy and hyperthermia as part of a surgical procedure in the management of patients with peritoneal carcinomatosis has gained prominence in recent years with selected patients showing benefit. Patients with peritoneal surface malignancy following cancer resection were treated with intraperitoneal hyperthermic (41.5–42.5°C) cisplatin and doxorubicin combined with the infusion of systemic ifosfamide chemotherapy. The concentrations of ifosfamide and 4-hydroxyifosfamide were determined in plasma, peritoneal fluid, urine, and when possible, within small tumor nodules less than 1 cm. Plasma concentrations of ifosfamide exceeded peritoneal fluid levels of ifosfamide during the 90 minutes of chemotherapy infusion. Both ifosfamide and 4-hydroxyifosfamide could be recovered from peritoneal tumor nodules throughout the 90 minutes of ifosfamide continuous infusion and exceeded plasma concentrations. 4-Hydroxyifosfamide within peritoneal surface cancer nodules suggested a favorable pharmacologic endpoint in the study of ifosfamide administered in the operating room.