Intraperitoneal hyperthermic chemotherapy (IPCH)

By | March 30, 2012

Intraperitoneal hyperthermic chemotherapy refers to a variety of ways to improve the body and (or) tumor tissue (local) temperature, thermal effects and secondary effects of the treatment of malignant tumors.Intraperitoneal hyperthermic chemotherapy (IPCH) The development and mechanism of peritoneal metastasis of gastric cancer recurrence after surgery is the primary mechanism for intra-abdominal free cancer cells grown in the peritoneal surface, and thus proliferating into cancer nodules. Systemic venous pathway through chemotherapy on the efficacy of prevention and treatment of peritoneal metastasis and recurrence of less than ideal for two main reasons: chemotherapy drugs in the blood can not be directly on the intraperitoneal free cancer cells; grown in the peritoneal surface of the internal lack of new small foci blood vessels, it is difficult to form an effective drug concentration in the environment. Another study showed that intra-arterial chemotherapy with conventional peritoneal metastasis and recurrence, it is difficult to achieve satisfactory results. Arterial lines were multiple peritoneal nutrition, including the visceral peritoneum of the blood supply from the celiac artery, superior mesenteric artery and superior mesenteric artery, while the parietal peritoneum by the brain artery, lumbar artery, hypogastric artery and umbilical artery blood supply, etc. . Commonly used intra-arterial infusion chemotherapy mainly selective catheter inserted into the primary foci of the nutritional artery and inject chemotherapy drugs, directly on the peritoneal area is extremely limited.
Intraperitoneal hyperthermic chemotherapy (IPCH) The development and mechanism of action is based mainly on the multiple effects of hyperthermia on cancer cells. At the molecular level, thermal effects can induce cancer cell membrane protein denaturation, making the maintenance of cells from the steady state of some of the molecular complexes such as receptors, transduction, or transcription enzyme dysfunction, disturbance of protein, DNA and RNA synthesis. At the cellular level, thermal effects can activate the lysosomal, destruction cytoplasm and nucleus, and because the process of cell division in the S phase and M phase are particularly sensitive to the warm, so warm effect can lead directly to S or M phase of cancer cell death. At the organizational level, thermal effects can interfere with tumor tissue anaerobic glycolysis of sugar, resulting in partial pressure of oxygen and the pH value decreased, resulting in acid environment within the tumor. In addition, the role of cancer tissue by thermal effects, you can not do like normal tissue to heat by dilation of blood vessels, causing tiny blood vessels within the tumor embolization, and then increased cancer cell hypoxia, acidosis, and nutritional intake disorders, and ultimately may lead to tumor cell degeneration and necrosis.
On the other hand, due to the existence of "a peritoneal plasma barrier" effect, by the intraperitoneal chemotherapy can be used to achieve high local drug concentration in the blood tube to maintain low concentrations of chemotherapy drugs based on molecular weight and lipophilic different intraperitoneal chemotherapy with the plasma concentration ranging from several times to several times. Hyperthermic intraperitoneal injection of chemotherapy drugs can not only directly enhance the tumoricidal effect, and because not cause serious systemic toxicity. In addition, the thermal effects can also greatly enhance the tumor cell sensitivity to certain chemotherapy drugs, the resulting effect is not simply additive effect, but the double relationship. For example, in 43 C conditions, the tumor cells to MMC intake increased to 78%, drug cytotoxicity from 30% to 50%. Thermal effects can also stimulate the body's immune system. Body hyperthermia heat generated when the grams of protein in the cell necrosis can be released into the blood, can fully activate the body's immune system to eliminate tumor cells in vivo. Hyperthermia can enhance the T lymphocytes, B lymphocytes and NK cells to enhance anti-tumor activity of the immune surveillance function.
Hyperthermia on the inhibition of tumor metastasis also is effective.Intraperitoneal hyperthermic chemotherapy (IPCH) The development and mechanisms of action, transfer and cultivation of malignant cancer cells spread depends on the decomposition of the extracellular matrix, breaking the tumor basement membrane. Cancer cells is the secretion of matrix metalloproteinases in tumor invasion and metastasis of the importance of extracellular matrix degrading enzymes, matrix metalloproteinase enzyme activity and tumor invasion and metastasis. Experiments confirmed, 42 C3h thermal effects can significantly inhibit tumor cell invasion activity, thereby inhibiting tumor metastasis tendency.

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