Intraperitoneal hyperthermic chemoperfusion
Encyclopedia
Intraperitoneal hyperthermic chemoperfusion (IPHC) is a type of hyperthermia therapy
used in combination with surgery in the treatment of advanced abdominal cancers. In this procedure, warmed anti-cancer drugs are infused and circulated in the peritoneal cavity
(abdomen) for a short period of time. The chemotherapeutic agents generally infused during IPHC are mitomycin-C and cisplatin
.
IPHC is also called hyperthermic intraperitoneal chemotherapy (HIPEC), intra-abdominal hyperthermic chemoperfusion, intraoperative chemohyperthermic peritoneal perfusion (CHPP), or the Sugarbaker technique, after Paul Sugarbaker, developer and advocate of this procedure.
It is generally considered an experimental cancer therapy.
), which may include the removal of all involved peritoneal areas. These procedures can be 8-10 hours long and carry a significant rate of complications. IPHC is also used for certain advanced stage tumors in the abdomen that have spread many small tumors throughout the abdomen, when surgery is not likely to be possible or effective.
The diseases most often treated with this method are cancer of the appendix
, colorectal cancer
, ovarian cancer
, desmoplastic small round cell tumor
and gastric cancer. It is also used for:
Hyperthermia therapy
Hyperthermia therapy is a type of medical treatment in which body tissue is exposed to slightly higher temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anti-cancer drugs...
used in combination with surgery in the treatment of advanced abdominal cancers. In this procedure, warmed anti-cancer drugs are infused and circulated in the peritoneal cavity
Peritoneal cavity
The peritoneal cavity is a potential space between the parietal peritoneum and visceral peritoneum, that is, the two membranes that separate the organs in the abdominal cavity from the abdominal wall...
(abdomen) for a short period of time. The chemotherapeutic agents generally infused during IPHC are mitomycin-C and cisplatin
Cisplatin
Cisplatin, cisplatinum, or cis-diamminedichloroplatinum is a chemotherapy drug. It is used to treat various types of cancers, including sarcomas, some carcinomas , lymphomas, and germ cell tumors...
.
IPHC is also called hyperthermic intraperitoneal chemotherapy (HIPEC), intra-abdominal hyperthermic chemoperfusion, intraoperative chemohyperthermic peritoneal perfusion (CHPP), or the Sugarbaker technique, after Paul Sugarbaker, developer and advocate of this procedure.
It is generally considered an experimental cancer therapy.
Use
IPHC is generally used after surgical removal of as much cancer as possible (debulkingDebulking
Debulking is the surgical removal of part of a malignant tumour which cannot be completely excised, so as to enhance the effectiveness of radiation or chemotherapy. It is used only in specific malignancies, as generally partial removal of a tumor is not considered a worthwhile intervention...
), which may include the removal of all involved peritoneal areas. These procedures can be 8-10 hours long and carry a significant rate of complications. IPHC is also used for certain advanced stage tumors in the abdomen that have spread many small tumors throughout the abdomen, when surgery is not likely to be possible or effective.
The diseases most often treated with this method are cancer of the appendix
Pseudomyxoma peritonei
Pseudomyxoma Peritonei is an uncommon tumor known for its production of mucin in the abdominal cavity. If left untreated, mucin will eventually build up to the point where it compresses vital structures: the colon, the liver, kidneys,stomach, spleen, pancreas, etc.Unlike most cancers, this disease...
, colorectal cancer
Colorectal cancer
Colorectal cancer, commonly known as bowel cancer, is a cancer caused by uncontrolled cell growth , in the colon, rectum, or vermiform appendix. Colorectal cancer is clinically distinct from anal cancer, which affects the anus....
, ovarian cancer
Ovarian cancer
Ovarian cancer is a cancerous growth arising from the ovary. Symptoms are frequently very subtle early on and may include: bloating, pelvic pain, difficulty eating and frequent urination, and are easily confused with other illnesses....
, desmoplastic small round cell tumor
Desmoplastic small round cell tumor
Desmoplastic small-round-cell tumor is classified as a soft tissue sarcoma. It is an aggressive and rare tumor that primarily occurs as masses in the abdomen. Other areas affected may include the lymph nodes, the lining of the abdomen, diaphragm, spleen, liver, chest wall, skull, spinal cord, large...
and gastric cancer. It is also used for:
- Mucinous Adenocarcinoma of Appendix
- Mesothelioma
- Low-Grade Sarcoma
Procedure
The procedure is divided into three stages:- Exploration: Here the surgeon will open the abdomen evaluate the peritoneal cancer.
- Debulking: In the debulking, or cytoreduction, phase of the procedure the surgeon will remove the visible tumor implants. However, even when all of the visible tumor is removed it is possible for microscopic cancer cells to still remain. The final stage of the procedure is meant to eliminate those cells.
- Chemoperfusion: Here the abdominal cavity is rinsed with a heated chemotherapy solution. Unlike systemic chemotherapy that is delivered in the blood stream, throughout the whole body, the chemotherapy in the HIPEC procedure is largely isolated in the peritoneal cavity. Therefore, a much higher concentration of chemotherapy can be utilized, while the toxicity and side-effects associated with systemic chemotherapy are minimized.
External links
- http://www.pmppals.org/hipec-treatment-centers.html International alphabetic listing of HIPEC treatment specialists
- HIPEC Treatment Video Library A collection of videos featuring interviews with doctors who perform the HIPEC procedure and patients who have undergone it.
- HIPEC for peritoneal cancer patient information