Intraperitoneal Chemotherapy: Effective treatment for some types of cancer
In recent years, advances have been incorporated that have helped improve the prognosis and quality of life of many patients.
Cancer affecting the internal tissue lining the abdominal wall, known as the peritoneum, is called peritoneal carcinomatosis, a disease historically considered to be a terminal condition.
In recent years, a treatment has been developed that has proven to be very effective in some cases: hyperthermic intraperitoneal chemotherapy (HIPEC), an alternative that can greatly improve the survival of some patients affected by this pathology.
The use of antineoplastic drugs (chemotherapy) applied directly to the peritoneum at high temperatures has been shown to control or slow down the development of some types of peritoneal carcinomatosis.
Dr. Cristián Cavalla, a gastrointestinal surgeon at Clínica Alemana, explains that the use of antineoplastic drugs (chemotherapy) applied directly to the peritoneum at high temperatures can control or slow down the development of some types of peritoneal carcinomatosis. To do this, the procedure must be performed together with a cytoreductive surgery to remove all cancerous implants or foci from the peritoneum.
In this regard, Dr. Ricardo Silva, a clinical oncologist at Clínica Alemana, explains that this is the standard treatment for rare diseases such as peritoneal pseudomyxoma and malignant peritoneal mesothelioma. “It is also an integral part of the multidisciplinary management of peritoneal metastases of colorectal origin in suitably selected patients. On the other hand, if it starts in the ovary, this alternative is still being evaluated through several studies whose preliminary results are encouraging,” he says.
An innovative treatment
Peritoneal carcinomatosis happens when malignant cells develop in the peritoneum, either from the same tissue or resulting from the spreading of tumors located in neighboring organs (digestive and gynecological cancer).
Dr. Silva explains that, unlike what was believed a few years ago, peritoneal metastases are now thought to be the first barrier that prevents spreading in some malignant tumors, thus expressing itself as a regional disease, that is, without cancer cells spreading beyond the affected area.
"In recent decades, multiple groups have gradually adopted the concept of 'regional metastases' in peritoneal carcinomatosis. This is the origin of the aggressive surgical cytoreduction management associated with hyperthermic intraperitoneal chemotherapy in some cases, which has increased the likelihood of controlling some types of malignant tumors in a sustained manner over time, improving the overall survival in very carefully selected patients,” said the oncologist.
How is the treatment performed?
Dr. Cavalla explains that hyperthermic intraperitoneal chemotherapy is performed by means of a surgical procedure, administering chemotherapy drugs directly into the abdominal cavity by means of a specially designed machine that maintains a constant flow at a high temperature and for typical a time period of 90 minutes.
It is a long surgery - between five and eight hours – and postoperative requires intensive care and the multidisciplinary support of specialized nurses, intensive care specialists, radiologists, nutritionists, oncologists and surgeons.
“At Clínica Alemana, we began applying this procedure this year and have obtained very good results”, concludes Dr. Cavalla.