Complications of heated intraperitioneal chemotherapy and strategies for prevention

Publisher Website
Google Scholar
Abstract
Heated intraperitoneal chemotherapy (HIPC) is a novel treatment designed to bring high concentrations of active cytotoxic agents in direct contact with tumor cells that are disseminated within peritoneal fluid or attached to the lining surfaces of the peritoneal cavity. This treatment is often combined with radical cytoreductive surgery (tumor debulking) and is therefore performed at the time of and in association with surgery. Heating is believed to have synergistic effects with chemotherapy, although to our knowledge this has not been extensively or systematically examined in human clinical studies. The potential ability of intraperitoneal administration of cytotoxic agents to increase peritoneal-to-plasma drug ratios, or the area under the curve (AUC), and thus to enhance the effectiveness of local therapy and to diminish systemic toxicity, is an attractive approach [1]. Hyperthermia can potentiate the cytotoxicity of a variety of anticancer agents, including mitomycin C (MMC), doxorubicin, lonidamine, and cisplatin [2–4]. For MMC, this synergism is enhanced under hypoxic conditions [5].