Rationale for hyperthermia with intraoperative intraperitoneal chemotherapy agents.
Hyperthermia is selectively cytotoxic for malignant cells due to inhibition of oxidative metabolism causing lower pH in the microenvironment of the malignant cells and tumor. The increased acidity increases lysosymal activity and subsequent cell death. Hyperthermia alone as a primary treatment modality for malignancy has largely been abandoned due to high morbidity and mortality and high recurrence rates. Advances in administration and monitoring of hyperthermia, especially for regional applications, has allowed for the use of hyperthemia in conjunction with other modalities of antineoplastic therapy. Hyperthermia has been shown to potentiate chemotherapy and radiation by several different mechanisms. HIIC uses the advantages of hyperthermia in conjunction with chemotherapy for the management of peritoneal carcinomatosis. Several different chemotherapy agents have been shown to have improved therapeutic index and efficacy when used with hyperthermia in the management of peritoneal carcinomatosis.
Sticca
Robert P
RP
Department of Surgery, University of North Dakota School of Medicine and Health Sciences, 501 North Columbia Road, Grand Forks, ND 58203, USA. rsticca@medicine.nodak.edu
Dach
Brian W
BW
D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007263:Infusions, Parenteral; D007432:Intraoperative Period; D008297:Male; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D010537:Peritoneum / Q000601:surgery*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome