Cytotoxic intracavitary chemotherapy.

The intracavitary administration of chemotherapeutic agents for their cytotoxic properties as therapy for tumors confined to body cavities has significant theoretical appeal. Pharmacokinetic evaluation of several clinically useful antineoplastic drugs has confirmed modeling predictions that suggested a major advantage for cavity exposure to the agents compared with that of the plasma when the drugs are delivered directly into the body cavity. As the direct penetration of the agents into tissue is quite limited, the greatest potential utility of this therapeutic approach would be in patients with microscopic residual disease following debulking surgery or as therapy for patients with a high risk of intraperitoneal recurrence. Major toxicities of this innovative technique include abdominal pain (chemical serositis) and infection. Additional clinical evaluation will be required to define a role for cytotoxic intracavitary chemotherapy in the management of malignant disease.