Safety and Effectiveness of High-Precision Hyperthermic Intraperitoneal Perfusion Chemotherapy in Peritoneal Carcinomatosis: A Real-World Study.

Mingchen Ba,Shuzhong Cui,Kunpeng Lin,Hui Long,Bohuo Zhang,Wanbo Wu,Yinbing Wu,Yinuo Tu,Yuanfeng Gong

doi:10.3389/fonc.2021.674915

Mingchen Ba, Shuzhong Cui + Show 7 more

Open Access

https://doi.org/10.3389/fonc.2021.674915

Copy DOI

Abstract

BackgroundHyperthermic intraperitoneal chemotherapy (HIPEC) has been reported to effectively control peritoneal carcinomatosis (PC) in various patient populations, but there is a lack of real-world data. This study aimed to examine the safety and effectiveness of HIPEC in patients with PC in a real-world setting.MethodsThis was a retrospective study of patients with PC treated with the high-precision BR-TRG-I type HIPEC device between December 2006 and December 2016. Vital signs during HIPEC and adverse events were recorded. Effectiveness was evaluated by total objective remission rate (ORR), which was based on ascites’ remission 4 weeks after HIPEC.ResultsA total of 1,200 patients were included. There were 518 males and 682 females, with a mean age of 58.6 ± 6.5 years (range, 32–76 years). Among the patients, 93.6% of the patients (1123/1200) successfully received the three sessions of HIPEC, 158 had massive ascites. The changes of vital signs during HIPEC were within acceptable ranges, and patients only had a transient fever and abdominal distension. Regarding the HIPEC-related complications, hemorrhage was observed in seven (0.6%) patients, anastomotic leakage in four (0.5%), and intestinal obstruction in eight (0.7%). Nine (0.8%, 9/1200) patients had CTCAE grade IV bone marrow suppression, and three (0.3%, 3/1200) patients had severe renal failure (SRF), which were considered to be drug-related. The ORR of malignant ascites was 95.6% (151/158).ConclusionThis real-world study strongly suggests that HIPEC was safe in treating PC patients with a low rate of adverse events and leads to benefits in PC patients with massive malignant ascites.

Highlights

Hyperthermic intraperitoneal chemotherapy (HIPEC) has been reported to effectively control peritoneal carcinomatosis (PC) in various patient populations, but there is a lack of real-world data
In HIPEC, the chemotherapeutic agents circulate into the abdominal cavity with a high, constant, and persistent drug concentration, with only small amounts of drugs entering the blood circulation system, which take full advantage of the synergism of hyperthermia and cytotoxic drugs and the pharmacokinetic advantage of intraperitoneal chemotherapy, and have fewer adverse effects than systemic chemotherapy [12,13,14]
As a new adjunctive therapy against Peritoneal carcinomatosis (PC), HIPEC has obvious advantages compared with simple systemic chemotherapy in terms of prevention and treatment of peritoneal metastasis from malignant tumors [15,16,17]

Summary

Introduction

Hyperthermic intraperitoneal chemotherapy (HIPEC) has been reported to effectively control peritoneal carcinomatosis (PC) in various patient populations, but there is a lack of real-world data. Hyperthermic intraperitoneal chemotherapy (HIPEC) has been reported to have satisfactory effectiveness in treating PC and malignant ascites secondary to PC [7,8,9,10]. Because PC represents a disseminated regional disease without proof of distant metastases [11], it can be treated with HIPEC regional therapy to prolong patients’ survival and improve prognosis [11]. As a new adjunctive therapy against PC, HIPEC has obvious advantages compared with simple systemic chemotherapy in terms of prevention and treatment of peritoneal metastasis from malignant tumors [15,16,17]

Objectives

Results

Conclusion