Rettenmaier Mark A, Mendivil Alberto A, Gray Crystal M, Chapman Amber P, Stone Michelle K, Tinnerman Erin J, Goldstein Bram H
Gynecologic Oncology Associates, Newport Beach , California , USA.
Int J Hyperthermia. 2015 Jun;31(4):396-402. doi: 10.3109/02656736.2015.1007399. Epub 2015 Feb 24.
Hyperthermic intraperitoneal chemotherapy (HIPEC) involves the continuous heating and circulation of chemotherapy throughout the abdominal cavity in an attempt to enhance cytotoxicity. Despite the potential of this chemotherapy procedure, there are scant anatomical temperature distribution studies reporting on this therapeutic process.
We prospectively evaluated the temperature of select anatomical (e.g. upper abdominal, mid-abdominal and supra-pubic) sites in 11 advanced stage ovarian cancer patients who were treated with consolidation HIPEC carboplatin (AUC 10). The temperature of the aforementioned anatomical regions and the inflow/outflow tubing was measured at baseline and at 15-min intervals until the procedure's completion.
The lowest observed mean composite temperature was 41.1 °C at the supra-pubic site whereas the highest temperature was 42.6 °C, in association with the inflow/outflow tubing. During the various time intervals we also ascertained that the lowest composite temperature was 40.9 °C at baseline (i.e. time 0), whereas the highest value (41.8 °C) occurred at multiple time periods (e.g., 15, 45 and 60 min).
The HIPEC temperature variation amongst the various abdominal sites and time intervals was minimal. We also discerned that uniform temperature distribution throughout the abdominal cavity was facilitated when the abdomen was both maximally distended with fluid and a high flow rate was maintained.
腹腔热灌注化疗(HIPEC)是指在整个腹腔内持续加热并循环化疗药物,以增强细胞毒性。尽管这种化疗方法具有潜力,但关于这一治疗过程的解剖学温度分布研究却很少。
我们前瞻性地评估了11例接受巩固性腹腔热灌注顺铂化疗(AUC 10)的晚期卵巢癌患者选定解剖部位(如上腹部、中腹部和耻骨上)的温度。在基线时以及每隔15分钟测量上述解剖区域和流入/流出管道的温度,直至手术完成。
观察到耻骨上部位的最低平均综合温度为41.1°C,而与流入/流出管道相关的最高温度为42.6°C。在不同的时间间隔内,我们还确定基线时(即时间0)的最低综合温度为40.9°C,而最高值(41.8°C)出现在多个时间段(如15、45和60分钟)。
不同腹部部位和时间间隔之间的腹腔热灌注化疗温度变化很小。我们还发现,当腹腔用液体充分扩张并保持高流速时,有助于在整个腹腔内实现均匀的温度分布。