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Hyperthermic Intraperitoneal Cemoperfusion (HIPEC)
is a promising approach to the treatment of advanced abdominal
and gynecological cancers. HIPEC can be either curative
or palliative, depending on the type of tumor and how
much of the tumor can be removed surgically. In cases
where the tumor is completely removed, HIPEC can also be
used as adjuvant therapy to try to keep the tumor from
recurring. Used immediately following cytoreductive
surgery, HIPEC has improved the quality of life and increased
the lifespan of some cancer patients. One study of patients
with gastric cancer and peritoneal metastasis found
that those who had only surgery had a median survival
rate of 8 months. Of the patients who had surgery and
HIPEC, 54 percent had a one year survival rate; 42 percent,
a three-year survival rate; and 31 percent, a five-year
survival rate.
HIPEC can be beneficial for several reasons:
- A chemotherapy “bath”
can access many hard-to-reach areas.
Many residual abdominal cancer cells are located within
the peritoneum, the membrane lining of the abdominal
and pelvic cavities. When chemotherapy bathes the
abdominal region, it has the ability to reach many
irregular and complex surfaces.
- Cancer cells are more
responsive to heated chemotherapy.
During HIPEC, the chemotherapeutic drug is heated up
to about 100º Fahrenheit. Studies have shown
that when chemotherapeutic agents such as adriamycin,
melphalan, mitomycin C, cisplatin, and bleomycin are
warmed, cancer cells are more responsive to their
cytotoxic effects.
- Regional chemotherapy
goes only where it’s needed.
Chemotherapy is a toxic and powerful drug. HIPEC is
a method of regional chemotherapy, meaning that it
is directed to the area where it is needed, rather
than travel throughout the entire body.
- HIPEC is a safe technique.
HIPEC is a straightforward procedure that has few potential
risks. It does extend the time a patient spends under
anesthesia, however, so patients in a frail condition
or with other health problems may not be candidates
for HIPEC.
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An
Overview of HIPEC
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