Abstract
Peritoneal metastases (PM) predominantly originate from primary cancers such as colorectal, ovarian and gastric cancer. Survival rates decrease dramatically when metastases develop in the peritoneal cavity. The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) offers a treatment option that can significantly prolong patients' lives. During surgery, the large visible tumor mass is removed from the peritoneal surface. Small microscopic tumors or isolated groups of tumor cells may not be visible to the naked eye during surgery and may increase the risk of recurrence months or even years later. Therefore, HIPEC is used to eradicate the residual microscopic disease. During HIPEC, a heated chemotherapeutic solution (39-43°C) is administered to the outer surface of tumor lesions in the peritoneum while perfusing the entire peritoneal cavity. The cytotoxic effect of chemotherapeutic agents is highly temperature dependent and it is therefore essential to achieve thermal homogeneity during treatment.
The research presented in this thesis describes the development, validation and application of treatment planning software for HIPEC based on the computational fluid dynamics (CFD) software package OpenFoam. The goal of this approach is to improve treatment homogeneity by simulating chemotherapeutic and thermal distributions in the peritoneal cavity. Preclinical in vitro and in vivo research can help determine optimal treatment conditions. The in silico research presented in this thesis can help guide treatment strategies to achieve these optimal conditions during HIPEC. The treatment planning software has been applied in several models at different scales of increasing complexity, resulting in clinically relevant insights into the dynamics during HIPEC. In addition, several validation experiments were performed to ensure the validity of the simulated results. The insights provided in this work regarding catheter placement, flow rate, and treatment temperature can help determine the best treatment strategy.
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The research presented in this thesis describes the development, validation and application of treatment planning software for HIPEC based on the computational fluid dynamics (CFD) software package OpenFoam. The goal of this approach is to improve treatment homogeneity by simulating chemotherapeutic and thermal distributions in the peritoneal cavity. Preclinical in vitro and in vivo research can help determine optimal treatment conditions. The in silico research presented in this thesis can help guide treatment strategies to achieve these optimal conditions during HIPEC. The treatment planning software has been applied in several models at different scales of increasing complexity, resulting in clinically relevant insights into the dynamics during HIPEC. In addition, several validation experiments were performed to ensure the validity of the simulated results. The insights provided in this work regarding catheter placement, flow rate, and treatment temperature can help determine the best treatment strategy.
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| Original language | English |
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| Qualification | Doctor of Philosophy |
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| Supervisors/Advisors |
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| Award date | 21 Jun 2023 |
| Print ISBNs | 9789493315662 |
| Publication status | Published - 2023 |