Intraperitoneal perfusion chemotherapy with hyperthermia in some malignant ascites

Area of Science:

• Oncology
• Surgical Oncology
• Pharmacology

Background:

• Malignant peritoneal diseases pose treatment challenges due to limited drug penetration.
• Intraperitoneal chemotherapy with hyperthermia (HIPEC) aims to improve local drug concentration and efficacy.
• Common HIPEC agents include cisplatin, doxorubicin, and mitomycin C.

Purpose of the Study:

• To review the application and outcomes of HIPEC in various cancers with peritoneal metastasis.
• To discuss the advantages and disadvantages of different HIPEC techniques.
• To highlight the role of laparoscopy in HIPEC patient selection and monitoring.

Main Methods:

• Review of clinical studies and data on HIPEC for peritoneal malignancies.
• Analysis of drug penetration, hyperthermia effects, and surgical factors.
• Discussion of closed vs. open HIPEC techniques and laparoscopic integration.

Main Results:

• HIPEC enhances local drug penetration and efficacy, with clinical hyperthermia at 41°C.
• Extended exposure and pressure improve drug penetration; hyperthermia synergizes with cytostatics.
• Complete cytoreductive surgery is vital for prognosis; closed HIPEC offers perfusion control.

Conclusions:

• HIPEC is a valuable treatment modality for peritoneal cancers like gastric, colorectal, and ovarian cancers, and mesothelioma.
• Optimizing drug concentration, perfusion techniques, and surgical cytoreduction are key to successful HIPEC.
• Laparoscopy plays a critical role in patient selection, treatment monitoring, and procedural guidance for HIPEC.