The role of hyperthermia on abdominal tissue concentrations of cisplatin during and after intraperitoneal chemotherapy – insights from a porcine model
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Epithelial ovarian cancer remains a leading cause of mortality among gynecological malignancies, with a high incidence of peritoneal carcinomatosis at diagnosis. Hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as a promising treatment for advanced-stage epithelial ovarian cancer, potentially improving recurrence-free and overall survival rates. The study aimed to investigate the impact of hyperthermia on cisplatin concentrations in healthy abdominal tissues by comparing HIPEC with normothermic intraperitoneal chemotherapy (NIPEC) in a novel porcine model. Sixteen cancer-free pigs underwent cytoreductive surgery followed by either HIPEC or NIPEC, with cisplatin administered intraperitoneally. Microdialysis was used to measure local cisplatin concentrations in various abdominal tissues over a 6-h period. The analysis revealed no statistically significant or clinically relevant difference in cisplatin concentrations between the HIPEC and NIPEC groups. In both groups, cisplatin concentrations were consistently higher in the peritoneum than in other tissues, and plasma levels were significantly lower than those in abdominal tissues. Hyperthermia did not enhance cisplatin's tissue penetration, suggesting that NIPEC may be an effective alternative to HIPEC, particularly for fragile and elderly patients. Future studies should investigate whether hyperthermia improves cisplatin delivery and cytotoxicity in tumor-infiltrated peritoneal tissues.