"Heated" chemotherapy helps pediatric patients with rare cancer live longer

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Pediatric patients with a rare cancer in their abdomen may benefit from an adult surgical procedure, according to a study published in the Journal of Pediatric Surgery (2010 May; 45(5):1000-6).

The study, led by Andrea Hayes-Jordan, MD, assistant professor at the M.D. Anderson Children's Cancer Hospital, involved 24 pediatric patients who had desmoplastic small round cell tumor (DSRCT), a rare and aggressive pediatric cancer.

Patients ranging in age from 5 to 25 years received a surgical procedure called hyperthermic intraperitoneal chemotherapy (HIPEC), or “heated” chemotherapy.

According to background information provided in the paper, with HIPEC, Dr. Hayes-Jordan will spend 10 to 12 hours removing tumors in a patient's abdominal cavity. Then chemotherapy, heated at 40°-41°C, is run throughout the cavity while the patient lies on a cooling blanket to keep the body's temperatures at a safe level.

Results of the study indicated that younger patients had better outcomes from HIPEC than did patients older than 18 years. Specifically, patients who received HIPEC had an overall 3-year survival rate of 71% compared to 26% for patients who received only the standard treatment.

“This study demonstrates that the surgical technique is safe and advantageous for patients who have multiple tumors in their abdomen,” said Dr. Hayes-Jordan. “In the past, these patients were told there was nothing else to be done, but now we can add months and often years to the lives of these young patients using this surgery.”

Researchers also reported that disease-free survival was also better for those who received HIPEC in addition to debulking surgery. Specifically, at 1 year, disease-free survival was 14% for those who received only debulking surgery compared to 53% who received HIPEC.

“Four years ago, we had little hope to give to families facing this disease we know very little about,” said Peter Anderson, MD, PhD, professor of pediatrics and senior author on the study. “Using a multimodality treatment that includes heated chemotherapy, we can see some of our patients experience milestones such as another birthday, a graduation, or even parenthood that they may not have had otherwise.”

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