A Temperature of 40 °C Appears to be a Critical Threshold for Potentiating Cytotoxic Chemotherapy In Vitro and in Peritoneal Carcinomatosis Patients Undergoing HIPEC

Annals of Surgical Oncology
Lea SchaafChristoph Ulmer

Abstract

Hyperthermic intraperitoneal chemotherapy (HIPEC) following cytoreductive surgery is a radical but effective treatment option for patients with peritoneal carcinomatosis (PC). Unfortunately, a standardized HIPEC protocol is missing impeding systematic comparisons with regard to minimal effective temperatures. The purpose of the present study was to systematically analyse the precise minimal temperature needed for potentiation of chemotherapy effects in vitro and for patient survival. We established a cell line-based model to mimic HIPEC conditions used in clinical practice, and evaluated intracellular drug concentrations and long-term survival using different temperatures ranging from 38 to 42 °C combined with cisplatin or doxorubicin. In parallel, we evaluated the temperature reached in the clinical setting by measuring inflow and outflow, as well as in two locations in the peritoneal cavity in 34 patients. Finally, we determined the influence of different HIPEC temperatures on survival. Long-term survival of cells treated with either cisplatin or doxorubicin was further improved only at temperatures above 40 °C. In patients, during HIPEC, constant temperatures were reached after 10 min in the peritoneal cavity. A temperature ...Continue Reading

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Citations

Mar 9, 2017·Revista do Colégio Brasileiro de Cirurgiões·Thales Paulo BatistaCristiano Souza Leão
Mar 27, 2019·Cancers·Ainhoa MadariagaAmit M Oza
Jul 5, 2018·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·D BleilerB Sinner
Dec 11, 2019·Der Anaesthesist·D BleilerB Sinner

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