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J. Clin. Med. 2018, 7(12), 567; https://doi.org/10.3390/jcm7120567

Systematic Review of Variations in Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Metastasis from Colorectal Cancer

1
Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seyler-Str. 3, D-72076 Tübingen, Germany
2
Department for Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
3
Department of Immunology, Interfaculty Institute for Cell Biology, University of Tübingen, Auf der Morgenstelle 15, D-72076 Tübingen, Germany
4
German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ) partner site Tübingen, Tübingen, Germany
5
Internal Medicine, Department for Oncology, Hematology, Immunology, Rheumatology and Pulmonology, University Hospital Tübingen, Otfried-Müller-Str. 10, D-72076 Tübingen, Germany
6
Department of Clinical Pharmacology, University Hospital Tübingen, Auf der Morgenstelle 8, D-72076 Tübingen, Germany
7
Department of Pharmacy and Biochemistry, University of Tübingen, Auf der Morgenstelle 8, D-72076 Tübingen, Germany
8
Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Auerbachstr. 112, D-70376 Stuttgart, Germany
These authors contributed equally to this work.
Current address: Department of General-, Visceral- and Thoracic Surgery, Feldkirch Academic Hospital, Carinagasse 47, A-6807 Feldkirch, Austria.
§
Current address: Department of General and Visceral Surgery, Schwarzwald-Baar Hospital, Klinikstr. 11, D-78052 Villingen-Schwenningen, Germany.
*
Author to whom correspondence should be addressed.
Received: 2 November 2018 / Revised: 5 December 2018 / Accepted: 10 December 2018 / Published: 19 December 2018
(This article belongs to the Section Pharmacology)
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Abstract

Background: Cytoreductive surgery (CRS), followed by hyperthermic intraperitoneal chemotherapy (HIPEC), combines radical surgery with abdominal heated chemotherapy, constituting a multimodal treatment approach. Since clear standards for HIPEC conduct in colorectal carcinoma (CRC) are lacking, we aimed to provide a comprehensive structured survey. Data sources and study eligibility criteria: A systematic literature search was performed in PubMed, with keywords “HIPEC” and “colorectal cancer”, according to established guidelines. Articles were systematically screened, selecting 87 publications complemented by 48 publications identified through extended search for subsequent synthesis and evaluation, extracting inter alia details on used drugs, dosage, temperature, exposure times, and carrier solutions. Results: Compiled publications contained 171 reports on HIPEC conduct foremost with mitomycin C and oxaliplatin, but also other drugs and drug combinations, comprising at least 60 different procedures. We hence provide an overview of interconnections between HIPEC protocols, used drugs and carrier solutions as well as their volumes. In addition, HIPEC temperatures and dosing benchmarks, as well as an estimate of in vivo resulting drug concentrations are demonstrated. Conclusions and implications: Owing to recent developments, HIPEC conduct and practices need to be reassessed. Unfortunately, imprecise and lacking reporting is frequent, which is why minimal information requirements should be established for HIPEC and the introduction of final drug concentrations for comparability reasons seems sensible. View Full-Text
Keywords: hyperthermic intraperitoneal chemotherapy; colorectal carcinoma; peritoneal metastasis; cytoreductive surgery; systematic review; PRISMA hyperthermic intraperitoneal chemotherapy; colorectal carcinoma; peritoneal metastasis; cytoreductive surgery; systematic review; PRISMA
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Yurttas, C.; Hoffmann, G.; Tolios, A.; Haen, S.P.; Schwab, M.; Königsrainer, I.; Königsrainer, A.; Beckert, S.; Löffler, M.W. Systematic Review of Variations in Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Metastasis from Colorectal Cancer. J. Clin. Med. 2018, 7, 567.

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