HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY – ONCOLOGY PHARMACY POINT OF VIEW

Hyperthermic intraperitoneal chemotherapy (HIPEC) involves perfusion the abdominal cavity with cytostatics, heated to 42 °C, for approximately 90 min. HIPEC is often performed after cytoreductive surgery. Mainly used cytostatics are cisplatin, carboplatin, less oxaliplatin, doxorubicin etc. The heat makes the drug more effective in killing cancer cells, and it also increases blood fl ow to the area. HIPEC is performed when standard systemic chemotherapy has limited efficacy because of the IV administered concentration of cytostatics in the abdomen is too low to destroy all present tumour cells. HIPEC is used to treat soft tissue sarcoma, appendix cancer, mesotelioma, colorectal carcinoma and ovarian cancer at stage of peritoneal carcinomatosis and other cancers in the abdominal cavity. HIPEC has comparatively serious side effects. Patients can develop hematological toxicity, CINV and renal failure. It is due to cytostatic penetration into the bloodstream. Detected plasmatic concentration are usually around lower limit of a therapeutic range. From oncology pharmacy point of view we shall think about suitable infusion solution and drug concentration with good stability in hypertermic conditions. We have to take care about an appropriate premedication and hydration. Handling cytostatic solution in operating room should follow standard oncology pharmacy procedure.

I haven’t any conflict of interest.