Drug selection for intraperitoneal infusion chemotherapy

There are numerous commonly used intraperitoneal infusion chemotherapy drugs, including cisplatin, carboplatin, nedaplatin, loplatin, oxaliplatin, fluorouracil, mitomycin, paclitaxel, thiotepa, mitoxantrone, etoposide, topotecan, bleomycin and irinotecan, etc. The specific drugs need to be selected according to the patient’s condition. Generally platinum is infused with cisplatin as commonly used, but the infusion of cisplatin should be hydrated with attention, i.e., a large amount of liquid should be used to minimize the side effects of cisplatin on the kidney, and carboplatin reaction is less than that of cisplatin. However, it is basically ineffective for tumors of the digestive system. Platinum oxalate, i.e. oxaliplatin, has neurotoxicity, and the incidence of pain and intestinal obstruction is relatively high, which is not easy to be perfused intraperitoneally. Recently, nedaplatin and loplatin have been found to have high efficiency and broad-spectrum low toxicity, and fluorouracil, hydroxycamptothecin, mitomycin, bleomycin, etc., can also be perfused intraperitoneally. Less commonly used chemotherapeutic drugs for intraperitoneal perfusion are adriamycin, which are now replaced by mitoxantrone. Paclitaxel is more effective in ovarian cancer and breast cancer, but it causes neurotoxicity and is more likely to cause abdominal pain and intestinal paralysis. Therefore, there are not many applications now, but the incidence of this type of chemical peritonitis is relatively high. Thoracic perfusion can be considered, but peritoneal perfusion is generally not considered, and cytotoxic drugs that are produced only after metabolism by the liver are not considered.