ABSTRACT
This chapter outlines basic principles of transport across the normal peritoneum and the underlying parenchymal tissue and the challenges of delivery to abnormal carcinomatous tissue. It presents some basic principles of anatomy and physiology, which affect drug transport from the cavity to tissue. Intraperitoneal (IP) delivery of multiple drugs for the treatment of cancer was developed in the United States by Vincent DeVita and colleagues at the National Cancer Institute in the 1970s and was termed the “belly bath”. IP chemotherapy is recommended for peritoneal surface metastases of ovarian carcinoma, colorectal cancer, gastric cancer, and pseudomyxoma peritonei. Physiologic characteristics of the peritoneal cavity, which cause it to be advantageous for removal of waste metabolites and poisons from the body, also provide an excellent portal of entry into the body for many drugs. The process of drug uptake from the peritoneal cavity includes the same physiological mechanisms responsible for transport during dialysis except that the direction of transport is reversed.
