A Study of Mitomycin C-Carbon Particle as an Intraperitoneal Chemotherapeutic Agent in Gastric Cancer Patients

Noh, Seung Moo

Abstract

BACKGROUND: Peritoneal recurrence is one of the most common relapse forms after curative surgery for a gastric adenocarcinoma, and this recurrence pattern is a big problem in the treatment of advanced gastric adenocarcinoma. The mitomycin C (MMC) adsorbed by activated charcoal particles (CH) is slowly released when the mitomycin C concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. This type of intraperitoneal chemotherapy may be a logical method to prevent or treat the peritoneal dissemination of the gastric cancer after a gastric cancer resection.
METHODS
One handred (100) mg of mitomycin C, 1,000 mg of activated carbon particles, and 100 ml of water were mixed and stirred for more than 7 minutes. For intraperitoneal chemotherapy for advanced gastric adenocarcinomas, The mitomycin C adsorbed on the activated carbon particles (MMC-CH) was spread on the peritoneal surface just before abdominal wall closure. Closed drainage tubes were inserted in the peritoneal cavity, one placed in the subhepatic space and another placed in the pelvic cavity, and clamped for two hours after MMC-CH application. The mitomycin C concentrations were serially measured in the peritoneal fluid from drainage, plasma, and urine at 2 hours, 24 hours, 48 hours, 72 hours, and 168 hours following its administration in order to study the efficacy of the MMC-CH as a slowly releasing drug-delivery system.
RESULTS
The mitomycin C concentrations in the peritoneal fluid were 3.62 microgram/ml at 2 hours after administration of the MMC-CH and 0.38 microgram/ml at 24 hours, the concentrations in plasma at 2 and 24 hours after MMC-CH administration were 1.10 microgram/ml and 0.21 microgram/ml, respectively, and those in urine were 3.94 microgram/ml and 17.6 microgram/ml.
CONCLUSIONS
The mitomycin C concentration of the peritoneal fluid was higher than that of the plasma, but the effective duration of maintenance was less than 24 hours in the peritoneal fluid.