Intraperitoneal photodynamic therapy for peritoneal carcinomatosis and sarcomatosis

The preliminary results of an ongoing Phase II trial of Photofrin-mediated intraperitoneal PDT (IP PDT) are presented. The clinical endpoints of this trial are to determine the response rates of patients with carcinomatosis and sarcomatosis to IP PDT and to document the toxicities of IP PDT in a defined patient population. Photofrin, 2.5 mg/kg, was administered intravenously 48 hours prior to debulking surgery and light delivery. 57 patients with ovarian cancer, gastrointestinal cancers, and sarcomas were enrolled. 44 patients received Photofrin and received light treatment. 39 patients are evaluable for response. 8 of 39 patients had a complete radiographic response to IP PDT 3 months after treatment. 3 patients are alive without evidence of disease 6, 6, and 9 months after treatment. 1 patient is alive has no evidence of intra-abdominal disease but has developed lung metastases. Toxicities include post-operative fluid shifts, hypotension, hydronephrosis, pleural effusions, enteric fistula? transient liver function test elevation, thrombocytopenia, and wound dehiscence. Toxicity is related to pre-operative tumor bulk and to the extensiveness of surgery required. IP PDT is feasible and leads to an initial clinical response rate of 25% in patients with incurable peritoneal carcinomatosis and sarcomatosis.