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Pressurized intraperitoneal aerosol chemotherapy (PIPAC)
Published in Wim P. Ceelen, Edward A. Levine, Intraperitoneal Cancer Therapy, 2015
Marc A. Reymond, W. Solass, C. Tempfer
Peritoneal sclerosis is a severe disease with no effective therapy that can lead to bowel obstruction [33,34] and, eventually, to death [35]. The development of peritoneal fibrosis is not recognized so far as a significant problem in peritoneal carcinomatosis patients, probably because this problem has a low relevance in patients with a short life expectation. Such an attitude might be acceptable in advanced, palliative situations but the problem will gain in importance when intraperitoneal chemotherapy might be applied earlier in the natural course of disease, for example, as a prophylaxis of peritoneal carcinomatosis in high-risk patients. By analogy, the intrapleural application of chemotherapy might induce a pleural fibrosis potentially inducing secondary restrictive lung disease. So far, there is a single report of interstitial pneumonia after hyperthermic intrathoracic chemotherapy (HITOC) [36].
Heating technology for malignant tumors: a review
Published in International Journal of Hyperthermia, 2020
H. Petra Kok, Erik N. K. Cressman, Wim Ceelen, Christopher L. Brace, Robert Ivkov, Holger Grüll, Gail ter Haar, Peter Wust, Johannes Crezee
Selected anatomical sites are suitable for perfusional hyperthermia techniques, generally combined with chemotherapy. One approach is the direct infusion of heated perfusate into the vascular system, for example for hyperthermic isolated limb perfusion (ILP). ILP involves temporarily connecting the circulatory system in the limb of the patient to an external pump to distribute both heat and drugs to the tumor target region, achieving relatively uniform heating and drug delivery in that region. Another approach is to circulate a hyperthermic carrier solution combined with chemotherapeutic agents inside body cavities to provide heating and drug delivery to tumors in the surface of the cavity. An example is Hyperthermic IntraPeritoneal Chemotherapy (HIPEC) which involves circulation of a heated chemotherapeutic solution in the peritoneal cavity to eradicate any microscopic tumors left behind after surgical removal of macroscopic tumor mass [53]. Hyperthermic intrathoracic chemotherapy (HITHOC) is a similar technique for intrathoracic lesions [54]. Hyperthermic Intra-Vesical Chemotherapy (HIVEC®) is another perfusion technique in which the bladder wall is treated by circulating a heated chemotherapy solution inside the bladder [55].
Systematic review of the registered clinical trials for oncological hyperthermia treatment
Published in International Journal of Hyperthermia, 2022
H. Peeters, E. M. van Zwol, L. Brancato, M. G. M. C. da Cunha, J. Bogers
Regional HT aims to heat a body cavity. It is most often used in combination with radiotherapy or administered as heated chemotherapy [6]. The most frequently used technique, hyperthermic intraperitoneal chemotherapy (HIPEC), aims to create a flow of heated chemotherapy through the abdominal cavity. HIPEC is most often used to treat gastro-intestinal [18] and gynecological tumors [19,20]. Other techniques to heat body cavities are being developed; these include hyperthermic intravesical chemotherapy (HIVEC) [21] and hyperthermic intrathoracic chemotherapy (HITOC) [22]. Last, isolated limb perfusion is a technique that temporarily replaces the blood in a limb with a heated chemotherapeutic agent. It is mainly used to treat soft tissues sarcomas [23] and melanomas [24].
Hyperthermic intrathoracic/intraperitoneal chemotherapy versus conventional intrapleural/intraperitoneal chemotherapy for the malignant effusion: a multi-center randomized clinical trial
Published in International Journal of Hyperthermia, 2023
Lili Liu, Tao Zhang, Xiang Song, Cheng-gong Liao, Tengyun Xu, Yang Yang, Ming Zeng, Junmei Jia, Haichuan Su, Yang Song, Jie Min, Hongmei Zhang, Wei Li, Hongwei Zhang, Helong Zhang
Patients with MPE and MA generally respond poorly to diuretics and sodium restriction. Repeated thoracentesis or paracentesis only temporarily relieve symptoms and may cause complications such as hypoproteinemia and electrolyte disorders. Effect of systemic chemotherapy in controlling MPE or MA is limited due to the poor blood supply to the pleural and peritoneal cavity. Intrapleural or intraperitoneal chemotherapy have potential advantages in treating underly malignancies and controlling MPE or MA. In this regard, direct injection of chemotherapeutic drugs into the pleural or peritoneal cavity can not only dramatically increase the chemotherapeutic effect with higher local concentrations of chemotherapeutic drugs, but also significantly reduce side effects by avoiding systemic toxicities of the chemotherapeutic drugs. Hyperthermic intrathoracic chemotherapy (HITHOC) and Hyperthermic intraperitoneal chemotherapy (HIPEC) are developed by the combination of conventional intrapleural or intraperitoneal chemotherapy and the biological effect of hyperthermia on cancer cells. Experimental evidence suggested that, comparing to normal cells, malignant cells are more sensitive to the effect of hyperthermia in the range of 41 °C to 43 °C, resulting in accelerated cell death. In clinical practice, synergetic effects between heat and chemotherapeutics in the enhancement of cytotoxicity to cancer cells have also been well documented [6–9]. Compared to conventional intrapleural or intraperitoneal chemotherapy, HITHOC and HIPEC have been shown significant clinical advantages in the treatment of malignant pleural or peritoneal effusions as well as preventing recurrence of the malignant effusion [10–15].