Many types and varieties of hyperthermia (heat treatment) are used in conventional cancer care, and some additional uses are being explored for improving survival and reducing risk of recurrence.
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This section does not replicate the other information on this topic but provides additional details or context most relevant to professionals.
Clinical practice guidelines for professionals
Eight recommendations are presented in this practice guideline:
- For patients with newly diagnosed stage III primary epithelial ovarian or fallopian tube carcinoma, or primary peritoneal carcinoma, HIPEC should be considered for those with at least stable disease after neoadjuvant chemotherapy at the time that interval cytoreductive surgery (CRS) (if complete) or optimal cytoreduction is achieved. There is insufficient evidence to recommend the addition of HIPEC when primary CRS is performed for patients with newly diagnosed advanced primary epithelial ovarian or fallopian tube carcinoma, or primary peritoneal carcinoma, outside of a clinical trial.
- There is insufficient evidence to recommend HIPEC with CRS in patients with recurrent ovarian cancer outside the context of a clinical trial.
- There is insufficient evidence to recommend HIPEC with CRS in patients with peritoneal colorectal carcinomatosis outside the context of a clinical trial.
- There is insufficient evidence to recommend HIPEC with CRS for the prevention of peritoneal carcinomatosis in colorectal cancer outside the context of a clinical trial; however, HIPEC using oxaliplatin is not recommended.
- There is insufficient evidence to recommend HIPEC with CRS for the treatment of gastric peritoneal carcinomatosis outside the context of a clinical trial.
- There is insufficient evidence to recommend HIPEC with CRS for the prevention of gastric peritoneal carcinomatosis outside the context of a clinical trial.
- There is insufficient evidence to recommend HIPEC with CRS as a standard of care in patients with malignant peritoneal mesothelioma; however, patients should be referred to HIPEC specialty centres for assessment for treatment as part of an ongoing research protocol.
- There is insufficient evidence to recommend HIPEC with CRS as a standard of care in patients with disseminated mucinous neoplasm in the appendix; however, patients should be referred to HIPEC specialty centres for assessment for treatment as part of an ongoing research protocol.
Chinese expert consensus 2016
This Chinese expert consensus summarizes the mechanism of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy to treat peritoneal carcinomatosis and its clinical efficacy in gastric cancer, colorectal cancer, ovarian cancer, pseudomyxoma peritonei, malignant peritoneal mesothelioma, and peritoneal sarcoma. Furthermore, a clinical pathway of CRS + HIPEC to treat peritoneal carcinomatosis has also been formulated.
Modes of action
“Hyperthermia amplifies immune responses in the body against cancer while decreasing the immune suppression and immune escape of cancer. It also shows that hyperthermia inhibits the repair of damaged cancer cells after chemotherapy or radiotherapy.”1Yagawa Y, Tanigawa K, Yamamoto M. Cancer immunity and therapy using hyperthermia with immunotherapy, radiotherapy, chemotherapy, and surgery. Journal of Cancer Metastasis and Treatment. 2017;3:218-230.
“The mechanism by which heat sensitizes cells for cDDP action seems to be the sum of multiple factors, which comprise heat effects on accumulation, adduct formation and adduct processing.”2Hettinga JV, Lemstra W et al. Mechanism of hyperthermic potentiation of cisplatin action in cisplatin-sensitive and -resistant tumour cells. British Journal of Cancer. 1997;75(12):1735-43.
Helpful links for professionals
Crezee H, van Leeuwen CM et al. Thermoradiotherapy planning: integration in routine clinical practice. International Journal Hyperthermia. 2016;32(1):41-9.
Anttinen M, Yli-Pietilä E et al. Histopathological evaluation of prostate specimens after thermal ablation may be confounded by the presence of thermally-fixed cells. International Journal of Hyperthermia. 2019;36(1):915-925.
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References