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intraperitoneal chemoperfusion

Deepa Magge, Lekshmi Ramalingam, Yongli Shuai, Robert P Edwards, James F Pingpank, Steven S Ahrendt, Matthew P Holtzman, Herbert J Zeh, David L Bartlett, Haroon A Choudry
BACKGROUND AND OBJECTIVES: The role of hyperthermic intraperitoneal chemoperfusion (HIPEC) in the multimodality treatment of ovarian peritoneal metastases (OPM) and primary peritoneal cancer (PPC) remains controversial. We hypothesized that cytoreductive surgery (CRS) and HIPEC would provide meaningful survival benefit without excessive morbidity. METHODS: We reviewed clinicopathologic and perioperative data following 96 CRS-HIPEC procedures for primary or recurrent OPM and PPC...
June 19, 2017: Journal of Surgical Oncology
Charlotte Carlier, Ada Mathys, Emiel De Jaeghere, Margo Steuperaert, Olivier De Wever, Wim Ceelen
Intraperitoneal (IP) drug delivery, either as an intraoperative chemoperfusion or as adjuvant, repeated instillation, is an established treatment modality in patients with peritoneal carcinomatosis. The efficacy of IP drugs depends on its ability to penetrate the tumor stroma in order to reach their (sub)cellular target. It is known, that drug penetration after IP delivery is limited to a few millimeters. Here, we review the basic tissue transport mechanisms after IP delivery, and discuss the biophysical barriers and obstacles that limit penetration distance...
March 28, 2017: International Journal of Hyperthermia
Afag Aghayeva, Cigdem Benlice, Ismail Ahmet Bilgin, Pinar Atukeren, Gulen Dogusoy, Figen Demir, Deniz Atasoy, Bilgi Baca
INTRODUCTION: Cytoreductive surgery (CRS) with subsequent hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising modality to treat and prevent peritoneal metastases. However, this treatment is associated with signficant morbidity and mortality. Whether or not CRS with HIPEC interferes with anastomotic healing has also been debated. This study was designed to investigate the effects of mitomycin C, cisplatin, oxaliplatin, and doxorubicin used in HIPEC treatment on colonic anastomosis healing in a rat model...
May 12, 2017: Tumori
Mashaal Dhir, Lekshmi Ramalingam, Yongli Shuai, Sam Pakrafter, Heather L Jones, Melissa E Hogg, Amer H Zureikat, Matthew P Holtzman, Steven A Ahrendt, Nathan Bahary, James F Pingpank, Herbert J Zeh, David L Bartlett, Haroon A Choudry
BACKGROUND: Several studies suggest that young patients may derive less oncologic benefit from surgical resection of cancers compared with older patients. We hypothesized that young patients may have worse outcomes following cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) for peritoneal metastases. METHODS: Perioperative and oncologic outcomes in adolescent and young adults (AYA), defined as younger than age 40 years (n = 135), undergoing CRS/HIPEC between 2001 and 2015 were reviewed and compared with middle-aged adults, defined as aged 40-65 years (n = 684)...
December 19, 2016: Annals of Surgical Oncology
Charlotte Carlier, Brecht Laforce, Stijn J M Van Malderen, Félix Gremonprez, Remi Tucoulou, Julie Villanova, Olivier De Wever, Laszlo Vincze, Frank Vanhaecke, Wim Ceelen
There is increasing interest in the treatment of advanced stage ovarian cancer (OC) using intraperitoneal (IP) delivery of platinum (Pt)-based chemotherapy. The antitumor efficacy of IP chemotherapy is determined by efficient tumor tissue penetration. Although it is assumed that Pt penetration is limited to a few millimeters after IP delivery, little is known on the distribution of Pt in different tumor compartments at the ultrastructural level following IP administration. Here, using synchrotron radiation X-ray fluorescence spectrometry (SR-XRF) and laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS), Pt distribution and penetration in OC peritoneal xenografts were determined at nanometer scale after IP chemoperfusion of cisplatin at 37-38°C or 40-41°C (hyperthermic)...
November 30, 2016: Journal of Pharmaceutical and Biomedical Analysis
Michael Alfred Ströhlein, Markus Maria Heiss, Karl-Walter Jauch
INTRODUCTION: Peritoneal carcinomatosis (PC) is a cancer disease with an urgent need for effective treatment. Conventional chemotherapy failed to show acceptable results. Cytoreductive surgery and hyperthermic chemoperfusion (HIPEC) are only beneficial in few patients with resectable peritoneal metastasis. Immunotherapy could be attractive against PC, as all requirements for immunotherapy are available in the peritoneal cavity. AREAS COVERED: This review analyzes the present literature for immunotherapy of PC...
October 2016: Expert Review of Anticancer Therapy
Yutaka Yonemura, Haruaki Ishibashi, Masamitu Hirano, Akiyoshi Mizumoto, Kazuyosi Takeshita, Kousuke Noguchi, Nobuyuki Takao, Masumi Ichinose, Yang Liu, Yan Li
BACKGROUND: The Peritoneal Cancer Index (PCI) is the most important prognostic factor following comprehensive treatment for peritoneal metastasis (PM) from gastric cancer (GCPM); however, 70 % of patients with GCPM showed a PCI score above the cut-off level at the time of diagnosis. Furthermore, neoadjuvant chemotherapy may reduce the PCI score to lower than the cut-off levels. In this study, the effects of neoadjuvant laparoscopic hyperthermic intraperitoneal chemoperfusion (NLHIPEC) and neoadjuvant intraperitoneal/systemic chemotherapy (NIPS) were investigated...
February 2017: Annals of Surgical Oncology
Michal Radomski, Reetesh K Pai, Yongli Shuai, Lekshmi Ramalingam, Heather Jones, Matthew P Holtzman, Steven A Ahrendt, James F Pingpank, Herbert J Zeh, David L Bartlett, Haroon A Choudry
BACKGROUND: The impact of histopathologic features on oncologic outcomes for patients with peritoneal metastases from goblet cell carcinoid (GCC) undergoing multimodality therapy, including cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (CRS-HIPEC), is unknown. METHODS: This study prospectively analyzed 43 patients with GCC undergoing CRS-HIPEC between 2005 and 2013. Pathology slides were re-reviewed to classify GCC into histologic subtypes according to the Tang classification...
July 11, 2016: Annals of Surgical Oncology
Yinuo Tu, Yunhong Tian, Zhiyuan Fang, Qiang Ruan, Hongsheng Tang, Xiangliang Zhang, Yinbing Wu, Yan Ding, Shuzhong Cui
AIM: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemoperfusion (HIPEC) is the treatment regime most likely to achieve prolonged survival in patients with peritoneal carcinomatosis from gastroenteric cancer. To date, few publications have focused on the treatment of patients with gastric cancer alone. Several controversies remain unsolved, including the safety and effectiveness of the CRS-HIPEC combination regime, particularly in cases where HIPEC is used as adjuvant treatment after CRS...
September 2016: International Journal of Hyperthermia
G I Gafton, K Yu Senchik, G S Kireeva, V G Petrov, V V Semiglazov, K D Guseynov, V G Bespalov, O A Belyaeva, A M Belyaev
AIM: To study the results of intraperitoneal chemoperfusion combined with cytoreductive procedure in patients with peritoneal pseudomyxoma. MATERIAL AND METHODS: For the period 2006--2015 seven patients with peritoneal pseudomyxoma underwent aggressive treatment using hyperthermic intraperitoneal chemoperfusion combined with cytoreductive procedure at the Department of General Oncology of N.N. Petrov Research Institute of Oncology. RESULTS: Two patients had postoperative complications...
2016: Khirurgiia
Y Yonemura, E Canbay, Y Li, F Coccolini, O Glehen, P H Sugarbaker, D Morris, B Moran, S Gonzaletz-Moreno, M Deraco, P Piso, D Elias, D Batlett, H Ishibashi, A Mizumoto, V Verwaal, H Mahtem
Recently, Peritoneal Surface Oncology Group International (PSOGI) developed a novel comprehensive treatment consisting of cytoreductive surgery (CRS) and perioperative chemotherapy (POC) for the treatment of peritoneal metastases (PM) from gastric cancer with curative intent. This article reviews the results of this treatment and verifies its indication. In this strategy, peritoneal cancer index (PCI) is determined by laparoscopy, and a peritoneal port is placed. Neoadjuvant bidirectional intraperitoneal/systemic chemotherapy (NIPS) is performed for 3 cycles, and then laparotomy is performed...
August 2016: European Journal of Surgical Oncology
Travis E Grotz, Paul F Mansfield, Richard E Royal, Gary N Mann, Safia Rafeeq, Karen A Beaty, Michael J Overman, Keith F Fournier
BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) is the preferred treatment for selected patients with mucinous appendiceal adenocarcinoma. Frequently, the hemidiaphragms are infiltrated with tumor, requiring partial diaphragm resection (DR) in order to obtain complete cytoreduction (CC-0). The clinical significance of diaphragmatic invasion and the optimum management to prevent transmission of disease from abdomen to chest is largely unknown. METHODS: This was a retrospective review of 78 patients with mucinous appendiceal adenocarcinoma undergoing cytoreduction and partial DR at a single institution between 2010 and 2014...
September 2016: Annals of Surgical Oncology
Laura A Lambert, Ariana Harris
Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) is being used more and more frequently for the management of peritoneal carcinomatosis. Despite significant improvements in oncologic outcomes and the risk of complications and mortality, CRS/HIPEC remains one of the most morbid treatments offered for advanced cancers. Consequently CRS/HIPEC is still considered controversial by many, even in the setting of cancers that are potentially curable. However, as high volume surgical oncologists become more experienced with CRS/HIPEC, the potential role of "palliative CRS/HIPEC" in the management of peritoneal carcinomatosis is being raised...
February 2016: Journal of Gastrointestinal Oncology
Johanna Verhulst
UNLABELLED: Introduction : Hyperthermic intraperitoneal chemotherapy (HIPEC) is becoming a standard therapy in the treatment of peritoneal carcinomatosis (PC). Compared to systemic chemotherapy, HIPEC improves survival in patients with PC. This therapy has high morbidity rates (up to 41%). In vitro it has been demonstrated that hyperthermia has a toxic effect on malign cells. However, hyperthermia also affects normal tissue. To my knowledge, any additional effect of hyperthermia combined with chemotherapy has never been demonstrated in a clinical setting...
2013: F1000Research
C Lu, L Li, Z Luo, Y Cui, P Fu, J Zhou, N Ma, Y Zhou
OBJECTIVES: To evaluate the clinical efficacy of systemic chemotherapy combined with intraperitoneal hyperthermic perfusion in advanced gastric cancer patients with malignant ascites. PATIENTS AND METHODS: Forty-eight gastric cancer patients with malignant ascites who were admitted to our hospital were selected and randomly divided into the hyperthermic perfusion and control groups. The control group only received systemic chemotherapy, and the hyperthermic perfusion group received systemic chemotherapy combined with intraperitoneal hyperthermic chemoperfusion...
2016: Neoplasma
Vladimir G Bespalov, Galina S Kireeva, Olesya A Belyaeva, Oleksiy E Kalinin, Konstantin Y Senchik, Alexandr N Stukov, Georgy I Gafton, Konstantin D Guseynov, Alexey M Belyaev
BACKGROUND AND OBJECTIVES: Hyperthermic Intraperitoneal Chemotherapy (HIPEC) at the time of Cytoreductive Surgery (CRS) is an actively researched treatment in patients with advanced ovarian cancer. Relative contribution of heat and chemotherapeutic agents during HIPEC as well as efficacy of a new agent dioxadet for regional chemotherapy in a rat model of ovarian cancer was studied. METHODS: Sixty rats were divided into three groups: no treatment control group (n = 19), hyperthermia without chemotherapy (HIPEP) (n = 14), HIPEC + cisplatin (n = 14), HIPEC + dioxadet (n = 13)...
March 2016: Journal of Surgical Oncology
Wouter Willaert, Kurt Van Der Speeten, Gabriel Liberale, Wim Ceelen
BACKGROUND: Selected patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC) benefit from cytoreductive surgery (CRS) combined with intraperitoneal chemoperfusion (IPC). However, even after optimal cytoreduction, systemic and locoregional recurrence are common. Perioperative chemotherapy with bevacizumab (BEV) may improve the outcome of these patients. METHODS/DESIGN: The BEV-IP study is a phase II, single-arm, open-label study aimed at patients with colorectal or appendiceal adenocarcinoma with synchronous or metachronous PC...
December 16, 2015: BMC Cancer
Karol Polom, Luigi Marano, Giandomenico Roviello, Roberto Petrioli, Riccardo Piagnerelli, Lorenzo de Franco, Daniele Marrelli, Franco Roviello
The number of new gastric cancer (GC) cases is decreasing, and these patients have longer survival thanks to new oncological treatments. In advanced GC a common evolution of this neoplasm is peritoneal metastases (PM). In the past this finding meant no chance for cure. However, today, using high quality operations and HIPEC, we are able to increase the number of patients treated with curative intention. New options in the diagnosis of PM, tumour susceptibility for different drugs, importance of quality of life, usage in ascites treatment, diagnostic tools in image-guided surgery, new targeted therapies and analysis of currently ongoing trials are presented together with today's knowledge of HIPEC efficacy in order to evaluate gastric PM...
2016: International Journal of Hyperthermia
V G Bespalov, G S Kireeva, O A Belyaeva, K Yu Senchik, A N Stukov, G I Gafton, L A Soloviev, M V Vasilchenko, K D Guseinov, V V Alexeev, A M Belyaev
A comparative study of safety and efficacy of normothermic and hyperthermic intraperitoneal chemoperfusion (IPEC and HIPEC) with cisplatin and dioxadet was carried out in 143 female Wistar rats. Ovarian cancer was inoculated intraperitoneally (i.p.). In 48 hours after ovarian cancer inoculation the drugs were administered i.p. or IPEC and HIPEC with the drugs were performed using maximum tolerated doses (MTD). Content of cisplatin was determined in the perfusate and blood plasma during HIPEC with the drug. The leukocyte count was measured using veterinary hematologic analyzer in peripheral blood of rats at different time points after HIPEC with dioxadet...
2015: Voprosy Onkologii
Eleanor Marshall Osborne, Tina Marie Briere, Andrea Hayes-Jordan, Lawrence B Levy, Winston W Huh, Anita Mahajan, Peter Anderson, Mary Frances McAleer
BACKGROUND AND PURPOSE: Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive malignancy. We report survival rates and toxicity associated with sequential multimodality treatment including whole abdominopelvic radiation therapy (WART). MATERIAL AND METHODS: Medical records of 32 patients with DSRCT treated at our institution were reviewed. Patients underwent chemotherapy, cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (HIPEC), followed by WART with intensity-modulated radiation or volumetric-modulated arc therapy...
April 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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