Understanding Thermal Perfusion Chemotherapy

  Postoperative abdominal and pelvic implant metastases in gastrointestinal and ovarian cancers are one of the main causes of recurrence and death in postoperative patients. In 1980, Sparrt firstly carried out the combination of local chemotherapy and heat therapy with continuous peritoneal heat perfusion chemotherapy (CHPP). Later, experts from the United States, Japan and other countries conducted a large number of systematic studies and gave full recognition to the thermal chemotherapy infusion treatment method, which was gradually applied in clinical practice.  Gastrointestinal cancer and ovarian cancer are prone to local recurrence and extensive intra-abdominal implantation and metastasis after surgery due to the presence of free cancer cells in the abdominal cavity or inability to completely remove the primary foci and metastases. Due to the existence of peritoneal-vascular barrier, traditional systemic chemotherapy is difficult to achieve effective therapeutic concentration in the peritoneal cavity, unable to control the growth of cancer cells and with high toxic side effects. The mechanism of abdominal thermochemotherapy to overcome the above disadvantages is multifaceted: 1. high local concentration of chemotherapeutic drugs, so that cancer cells are immersed in high concentration of chemotherapeutic drugs, which increases the killing power with less toxic side effects; 2. thermochemotherapy increases the permeability of chemotherapeutic drugs and increases the potency of chemotherapeutic drugs; 3. warmth causes destruction of tumor blood vessels, tumor vascular embolization and inhibition of tumor neovascularization; 4. intraoperative and early postoperative period due to The tumor load is small, tumor cell division and proliferation is accelerated, and it is sensitive to chemotherapeutic drugs. Meanwhile, in the early postoperative period, due to the lighter abdominal adhesions, the intra-abdominal chemotherapeutic drugs and temperature are more uniform, which is conducive to the killing of cancer cells.  Intraperitoneal thermal chemotherapy infusion therapy obviously reduces the tumor recurrence rate and prolongs the survival of patients. For patients with advanced malignant ascites, abdominal thermal chemotherapy infusion therapy can significantly improve the control rate of malignant ascites, reduce abdominal pain, abdominal distension and other symptoms, and improve the quality of life compared with conventional treatment. In August 2002, Zhang Qiang, director, Yin Chunzhu, deputy director and all the medical staff of the Department of Abdominal Surgery II of Jilin Cancer Hospital took the lead in carrying out early postoperative abdominal thermal chemotherapy infusion therapy in China and achieved remarkable efficacy. It has won the attention of domestic and foreign experts and scholars, and filled the gap in this treatment field in China.