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Percutaneous venovenous perfusion-induced systemic hyperthermia for lung cancer: a phase I safety study
Joseph B Zwischenberger1, Roger A Vertrees, Eric A Bedell
1Department of Surgery, The University of Texas Medical Branch, Galveston, Texas 77551-0528, USA. jzwische@utmb.edu
Background:
Veno-venous perfusion-induced systemic hyperthermia (VV-PISH) homogeneously raises core body temperature potentially improving outcomes from metastatic lung cancer.
Methods:
Patients (n = 10) with stage IV lung cancer, received VV-PISH (>or= 42 degrees C to
Results:
The first three patients helped in refining the technique and reflect an evolutionary process, therefore their data are not included as part of the VV-PISH cohort. Venovenous perfusion-induced systemic hyperthermia (n = 7) had a preoperative weight loss of 4.4 +/- 2.8 Kg, and a Karnofsky score of >or= 70. Time to target temperature was 47 +/- 2 minutes, as electrolytes remained normal, without patient or circuit complications. Extubation occurred between 6 and 18 hours. Hospital stay was 4.6 +/- 1.1 days; median length-of-survival after hyperthermia was 271 days. For concurrent controls (n = 16, stage IV lung cancer), median length-of-survival from time of diagnosis to death was 96 days, but for the VV-PISH patients it was significantly longer at 450 days (p < 0.05). All patients returned to pretreatment status following treatment and died from progression of lung cancer.
Conclusions:
Venovenous perfusion-induced systemic hyperthermia is safe, technically feasible, and achieves target temperature. Survival may be enhanced in stage IV lung cancer.
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