TY - JOUR
T1 - Demonstration of treatment planning software for hyperthermic intraperitoneal chemotherapy in a rat model
AU - Löke, Daan R.
AU - Helderman, Roxan F. C. P. A.
AU - Rodermond, Hans M.
AU - Tanis, Pieter J.
AU - Streekstra, Geert J.
AU - Franken, Nicolaas A. P.
AU - Oei, Arlene L.
AU - Crezee, Johannes
AU - Kok, H. Petra
N1 - Publisher Copyright: © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is administered to treat residual microscopic disease after cytoreductive surgery (CRS). During HIPEC, fluid (41–43 °C) is administered and drained through a limited number of catheters, risking thermal and drug heterogeneities within the abdominal cavity that might reduce effectiveness. Treatment planning software provides a unique tool for optimizing treatment delivery. This study aimed to investigate the influence of treatment-specific parameters on the thermal and drug homogeneity in the peritoneal cavity in a computed tomography based rat model. Method: We developed computational fluid dynamics (CFD) software simulating the dynamic flow, temperature and drug distribution during oxaliplatin based HIPEC. The influence of location and number of catheters, flow alternations and flow rates on peritoneal temperature and drug distribution were determined. The software was validated using data from experimental rat HIPEC studies. Results: The predicted core temperature and systemic oxaliplatin concentration were comparable to the values found in literature. Adequate placement of catheters, additional inflow catheters and higher flow rates reduced intraperitoneal temperature spatial variation by −1.4 °C, −2.3 °C and −1.2 °C, respectively. Flow alternations resulted in higher temperatures (up to +1.5 °C) over the peritoneal surface. Higher flow rates also reduced the spatial variation of chemotherapy concentration over the peritoneal surface resulting in a more homogeneous effective treatment dose. Conclusion: The presented treatment planning software provides unique insights in the dynamics during HIPEC, which enables optimization of treatment-specific parameters and provides an excellent basis for HIPEC treatment planning in human applications.
AB - Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is administered to treat residual microscopic disease after cytoreductive surgery (CRS). During HIPEC, fluid (41–43 °C) is administered and drained through a limited number of catheters, risking thermal and drug heterogeneities within the abdominal cavity that might reduce effectiveness. Treatment planning software provides a unique tool for optimizing treatment delivery. This study aimed to investigate the influence of treatment-specific parameters on the thermal and drug homogeneity in the peritoneal cavity in a computed tomography based rat model. Method: We developed computational fluid dynamics (CFD) software simulating the dynamic flow, temperature and drug distribution during oxaliplatin based HIPEC. The influence of location and number of catheters, flow alternations and flow rates on peritoneal temperature and drug distribution were determined. The software was validated using data from experimental rat HIPEC studies. Results: The predicted core temperature and systemic oxaliplatin concentration were comparable to the values found in literature. Adequate placement of catheters, additional inflow catheters and higher flow rates reduced intraperitoneal temperature spatial variation by −1.4 °C, −2.3 °C and −1.2 °C, respectively. Flow alternations resulted in higher temperatures (up to +1.5 °C) over the peritoneal surface. Higher flow rates also reduced the spatial variation of chemotherapy concentration over the peritoneal surface resulting in a more homogeneous effective treatment dose. Conclusion: The presented treatment planning software provides unique insights in the dynamics during HIPEC, which enables optimization of treatment-specific parameters and provides an excellent basis for HIPEC treatment planning in human applications.
KW - HIPEC
KW - computational fluid dynamics
KW - heated chemotherapy
KW - oxaliplatin
KW - peritoneal metastasis
KW - treatment planning software
UR - http://www.scopus.com/inward/record.url?scp=85099822285&partnerID=8YFLogxK
U2 - https://doi.org/10.1080/02656736.2020.1852324
DO - https://doi.org/10.1080/02656736.2020.1852324
M3 - Article
C2 - 33487083
SN - 0265-6736
VL - 38
SP - 38
EP - 54
JO - International journal of hyperthermia
JF - International journal of hyperthermia
IS - 1
ER -