Löke Daan R, Kok H Petra, Helderman Roxan F C P A, Franken Nicolaas A P, Oei Arlene L, Tuynman Jurriaan B, Zweije Remko, Sijbrands Jan, Tanis Pieter J, Crezee Johannes
Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers (UMC), University of Amsterdam, Amsterdam, Netherlands.
Laboratory for Experimental Oncology and Radiobiology, Center for Experimental and Molecular Medicine, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, Netherlands.
Front Oncol. 2023 Feb 14;13:1102242. doi: 10.3389/fonc.2023.1102242. eCollection 2023.
CytoReductive Surgery (CRS) followed by Hyperthermic IntraPeritoneal Chemotherapy (HIPEC) is an often used strategy in treating patients diagnosed with peritoneal metastasis (PM) originating from various origins such as gastric, colorectal and ovarian. During HIPEC treatments, a heated chemotherapeutic solution is circulated through the abdomen using several inflow and outflow catheters. Due to the complex geometry and large peritoneal volume, thermal heterogeneities can occur resulting in an unequal treatment of the peritoneal surface. This can increase the risk of recurrent disease after treatment. The OpenFoam-based treatment planning software that we developed can help understand and map these heterogeneities.
In this study, we validated the thermal module of the treatment planning software with an anatomically correct 3D-printed phantom of a female peritoneum. This phantom is used in an experimental HIPEC setup in which we varied catheter positions, flow rate and inflow temperatures. In total, we considered 7 different cases. We measured the thermal distribution in 9 different regions with a total of 63 measurement points. The duration of the experiment was 30 minutes, with measurement intervals of 5 seconds.
Experimental data were compared to simulated thermal distributions to determine the accuracy of the software. The thermal distribution per region compared well with the simulated temperature ranges. For all cases, the absolute error was well below 0.5°C near steady-state situations and around 0.5°C, for the entire duration of the experiment.
Considering clinical data, an accuracy below 0.5°C is adequate to provide estimates of variations in local treatment temperatures and to help optimize HIPEC treatments.
细胞减灭术（CRS）联合热灌注化疗（HIPEC）是治疗诊断为腹膜转移（PM）患者的常用策略，这些患者的腹膜转移源自各种原发部位，如胃、结肠和卵巢。在HIPEC治疗期间，一种加热的化疗溶液通过多个流入和流出导管在腹腔内循环。由于腹腔复杂的几何形状和较大的腹膜容积，可能会出现热不均匀性，导致腹膜表面治疗不均等。这会增加治疗后疾病复发的风险。我们开发的基于OpenFoam的治疗计划软件有助于理解和描绘这些不均匀性。
在本研究中，我们使用女性腹膜的解剖学正确的3D打印模型对治疗计划软件的热模块进行了验证。该模型用于实验性HIPEC设置中，我们改变了导管位置、流速和流入温度。总共，我们考虑了7种不同情况。我们在9个不同区域共63个测量点测量了热分布。实验持续时间为30分钟，测量间隔为5秒。
将实验数据与模拟热分布进行比较，以确定软件的准确性。每个区域的热分布与模拟温度范围比较吻合。对于所有情况，在接近稳态的情况下，绝对误差远低于0.5°C，在整个实验过程中约为0.5°C。
考虑到临床数据，低于0.5°C的精度足以提供局部治疗温度变化的估计，并有助于优化HIPEC治疗。
