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.