title: Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Methodology, Drugs and Bidirectional Chemotherapy.
abstract: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) combined have been recognized as standard of care for treatment of a subset of patients with peritoneal carcinomatosis (PC). The aim of CRS is to eliminate all macroscopic disease through a series of visceral resections followed by targeting any residual microscopic disease with intraperitoneal chemotherapy, exposing the peritoneal surfaces to a high concentration of chemotherapy with a lower systemic toxicity. Different regimes of intraperitoneal chemotherapy include HIPEC, early postoperative intraperitoneal chemotherapy (EPIC) and bidirectional chemotherapy. The efficacy and modality of treatment with intraperitoneal chemotherapy is dependent on multiple factors including the chosen cytotoxic agent and its pharmacokinetics and pharmacodynamics. There is no standardized methodology for intraperitoneal chemotherapy administration. This review will discuss the pharmacological principles of the various intraperitoneal chemotherapy techniques.
authors.affiliation: Department of Surgery, University of New South Wales & St George Hospital, Kogarah, Australia.
authors.forename: S J
authors.identifier: 0000-0002-1696-2912
authors.initials: SJ
authors.lastname: Valle
authors.affiliation: Department of Surgery, University of New South Wales & St George Hospital, Kogarah, Australia ; College of Medicine, Al-Iman Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.
authors.forename: N A
authors.initials: NA
authors.lastname: Alzahrani
authors.affiliation: Department of Surgery, University of New South Wales & St George Hospital, Kogarah, Australia ; Cancer Care Centre, St George Hospital, Kogarah, Australia.
authors.forename: W
authors.initials: W
authors.lastname: Liauw
authors.affiliation: Center for Gastrointestinal Malignancies, MedStar Washington Hospital Center, Washington, DC USA.
authors.forename: P H
authors.initials: PH
authors.lastname: Sugarbaker
authors.affiliation: Department of Surgical Oncology, Fortis Hospital, Bangalore, India.
authors.forename: A
authors.initials: A
authors.lastname: Bhatt
authors.affiliation: Department of Surgery, University of New South Wales & St George Hospital, Kogarah, Australia.
authors.forename: D L
authors.initials: DL
authors.lastname: Morris
keywords: Bidirectional chemotherapy; Cytoreductive surgery (CRS); Hyperthermic intraperitoneal chemotherapy (HIPEC); Methodology; Peritoneal carcinomatosis (PC)