Intraperitoneal hyperthermic

IPHC, Intraperitoneal hyperthermic chemoperfusion/chemotherapy MMC, Mitomycin C IP, Intraperitoneal SOD, Superoxide dismutase Nd YAG, Neodymium-doped yttrium aluminium garnet Nd Y3A15012 NIR, Near infrared FITC, Fluorescein isothiocyanate PEG, Polyethylene glycol FA, Fohc acid CDDP, Cisplatin TEM, Transmission electron microscopy... 

Fig. 10.9 Circuit diagram for intraperitoneal hyperthermic chemoperfusion. Warmed chemotherapeutic agents are circulated through the abdomen and temperature at the inflow and outflow ports are continuously monitored (Reprinted from Reingruber et al., 2007. With permission from Elsevier) (See Color Plates)... 

Levine EA, Stewart JH, Russell GB, Geisinger KR, Loggie BL, Shen P (2007) Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal surface malignancy experience with 501 procedures. Journal of the American College of Surgeons 204 943-953. 

Stewart JH, Shen P, Levine EA (2005) Intraperitoneal hyperthermic chemotherapy for peritoneal surface malignancy current status and future directions. Annals of Surgical Oncology 12 765-777. 

Deraco M, Gronchi A, Mazzaferro V et al (2002) Feasibility of peritoneotomy associated with intraperitoneal hyperthermic perfusion in patients with pseudomyxoma peritonei. Tumori 88(5) 370-375... 

The effect of nonfatal injuries such as a 2-hour period of bilateral hind-limb ischemia or a full-thickness scald of 20% of skin surface on the LDso of DNOC and its hyperthermic effect were evaluated in male rats (Stoner 1969). The intraperitoneal LDs° of DNOC was significantly (p<0.001) reduced from 24.8 to 26.2 mg/kg to 14 mg/kg DNOC when DNOC was given 1.5- 24 hours after either type of nonfatal injury. The authors concluded that the toxicity of DNOC was increased by previous trauma. These investigators proposed that this interaction was associated with sequential blocking of the tricarboxylic acid cycle with inhibition of citrate synthetase reaction during the early part of the response to the injury. Because DNOC acts as an uncoupler of oxidative phosphorylation, less ATP is produced. Therefore, the effects of trauma will be enhanced by an uncoupling agent such as DNOC. 

In an attempt to determine the best treatment regimen for mice given intraperitoneal doses of 4,6-dinitro-o-cresol (DNOC), which, like 2,4-DNP, uncouples oxidative phosphorylation and is hyperthermic, the effect of hypothermic dinitrophenols (i.e., 2,3-DNP, 2,5-DNP, and 3,4-DNP) on the lethality of DNOC was studied (Harvey 1959). At a dose of 10 mg/kg, DNOC itself resulted in 100% mortality. When the hypothermic DNPs were given immediately after DNOC, mortality was 60% after 2,3-DNP, 100% after 2,5-dinitrophenol, and 50% after 3,4-dinitrophenol. 2,4-DNP, which, like DNOC, is hyperthermic, afforded no protection of the mice. 

Pharmacokinetic Principles 33 Dose-Response Relationship 34 Intraperitoneal Application 34 Intra-arterial Application 34 Isolated Perfusion Techniques Application Techniques 35 Intracavitary Application 35 Intra-arterial Infusion 36 Regional Perfusion Techniques Stop-Flow Perfusions 36 Isolated Extremity Perfusion (ILP) 37 Hyperthermic Peritoneal Perfusion (HIPEC) 38 Clinical Indications 38 Pancreas Carcinoma 38 Bronchial Carcinoma 39 Extremity Sarcoma 40 Peritoneum 41 Surgical Technique 41 Rationale 42 Clinical Results 43 References 44 Further Reading 45... 

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