Introduction

Peritoneal sarcomatosis (PS) of rhabdomyosarcoma (RMS) is rare in children and has been reported only in smaller case series. The prognosis of these children is still sobering and it represents a therapeutic challenge due to high probability of tumor recurrence. In the past, treatment of PS in childhood was limited to aggressive surgical excision, radiotherapy, and chemotherapy with a palliative intention. Due to recent advances, cytoreductive surgery (CRS) in combination with hyperthermic intraperitoneal chemotherapy (HIPEC) have been established as a novel treatment option for PS and might prolong remission . Based on the therapeutic success in the treatment of PS in adults CRS and HIPEC were used successfully in a phase-I-trial in children and young adults with PS of RMS and others . Hayes-Jordanet al. confirmed an improvement of overall survival after CRS and HIPEC in children with PS of desmoplastic small round cell tumor (DSRCT) in combination with radiotherapy whereas it remains unclear if either CRS or HIPEC or radiotherapy or the combination of all determines the therapeutic success . Besides therapeutic benefits HIPEC was well tolerated in terms of toxicity and side effects in a case series of children (<5 years) with PS of RMS .
Despite recent promising clinical reports and due the rarity of CRS and HIPEC in PS in children, there is still a lack of knowledge regarding the best choice of chemotherapeutic drugs and concentration, optimal drug combination, treatment duration and local effects like penetration depth of chemotherapy during HIPEC. To answer these questions, we intended to establish a murine animal model of PS of RMS for further evaluation.