[Continuous hyperthermic peritoneal perfusion (CHPP) therapy in advanced gastric cancer]

Area of Science:

• Oncology
• Pharmacology
• Surgical Oncology

Context:

• Advanced gastric cancer treatment often involves hyperthermia and chemotherapy.
• Chemotherapy perfusion pump (CHPP) therapy is used to deliver heated chemotherapy intraperitoneally.
• Maintaining optimal intraperitoneal temperature is crucial for CHPP efficacy.

Purpose:

• To evaluate the effect of increased infusion rates on intraperitoneal temperature and drug concentrations during CHPP for advanced gastric cancer.
• To determine if higher infusion rates improve the therapeutic temperature range within the peritoneal cavity.
• To assess systemic drug absorption (CDDP and MMC) at different infusion rates.

Summary:

• CHPP therapy for advanced gastric cancer used cisplatin (CDDP) and mitomycin C (MMC) in warmed saline.
• Increasing the infusion rate from 200 ml/min to 400 ml/min raised intraperitoneal temperature but did not consistently reach effective ranges.
• Maximal plasma concentrations of CDDP and MMC were not significantly different between the two infusion rates.
• Portal venous MMC concentrations were higher than peripheral venous concentrations, but the difference was less pronounced than in animal studies.

Impact:

• Higher CHPP infusion rates can increase intraperitoneal temperatures, potentially enhancing hyperthermia's effect.
• Systemic absorption of CDDP and MMC remains low and is not significantly affected by the tested infusion rate increase.
• Findings suggest a need for further optimization of CHPP protocols to achieve consistent therapeutic temperatures and minimize systemic exposure.