ABSTRACT
In this chapter, the authors discuss some of the techniques for delivery of intracavitary chemotherapy and the technologies employed with them. Intracavitary chemoperfusion is generally coupled with a complete cytoreductive surgery in which complete extirpation of the tumor is undertaken before administering chemotherapy. The goal of chemoperfusion is to achieve high tissue concentrations of the cytotoxic drug, with a favorable plasma–peritoneal area under the curve (AUC). While chemoperfusion has also been employed in the neoadjuvant or palliative setting, the majority of the discussion pertains to the curative paradigm of chemoperfusion. Bicavitary chemoperfusion has also been described for patients undergoing chemoperfusion for disease spread to both cavities or for patients undergoing diaphragmectomies for peritoneal disease, thus leading to violation of the thoracic–abdominal barrier. Hyperthermia during chemoperfusion is delivered by heating the chemoperfusate solution. In animal models, higher flow rates equated with better drug delivery and favorable plasma–peritoneal AUC.
