A National Leader in Hyperthermic Intraperitoneal Chemotherapy скачать в хорошем качестве

A National Leader in Hyperthermic Intraperitoneal Chemotherapy

Wake Forest Baptist Health oncologist Edward A. Levine, MD, discusses clinical and research expertise in Hyperthermic Intraperitoneal Chemotherapy (HIPEC). More about HIPEC: http://www.wakehealth.edu/Comprehensi... Cancer research at Wake Forest Baptist: http://www.wakehealth.edu/Research/Co... TRANSCRIPT: DR. EDWARD LEVINE/SURGICAL ONCOLOGY: The HIPEC procedure represents a significant advance in the approach of patients who have had tumors which have spread inside the peritoneal cavity and other places. This gives us real options with the hope of long-term, disease-free survival with good quality of life. Where before, there frankly was none. Wake Forest Baptist Medical Center enjoys one of the largest experiences in the world with cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy. We've performed this complex procedure in over a thousand patients. The procedure is performed for our patients who have had tumors disseminated through the peritoneal cavity. It is a combination of aggressive cytoreductive surgery- which removes all the gross disease that we can see or feel- and then to treat microscopic residual disease- which we know remains- we use intraperitoneal chemotherapy delivered at the time of the operation. Typically at about 105 degrees for two hours. The first procedure was performed here on December 30, 1991. So we have been doing it for approximately 21 years. Again, one of the longest experiences with this procedure worldwide. HIPEC combines aggressive cytoreductive surgery with an attempt to remove all gross disease- where conventional surgery will simply usually bypass or make a colostomy or ileostomy for the patient. Clearly, we're trying to control the disease in the peritoneum rather than just palliate it. One of the key advantages of this procedure is being able to deliver chemotherapy in the operating room directly pouring chemotherapy on the tissue. We can deliver substantially greater concentrations of chemotherapy to tumor cells than would be available with even the most aggressive intravenous dosing. Now this procedure is not intended as an alternative to systemic chemotherapy, but for many patients, actually it works hand-in-glove with the medical oncologist by delivering systemic chemotherapy for diseases which may have a systemic… metastatic threat as well as working to control the intraperitoneal spread of the disease- which for many patients becomes the dominant prognostic factor. We have worked with many of our patients who have come to us for these HIPEC procedures in doing a number of research trials. Specifically, we have done the largest experience on quality of life after these procedures. We do a number of research studies looking at newer drugs- agents and delivery vehicles for better agents for the procedure. More recently, we have done the first study looking at cancer of the appendix- looking at a genomic approach and trying to figure out what are the genes that actually makes these tumors tick and give the patients the problem that they do, with the hope that we can find new targets to treat these patients with agents which have not yet been considered for cancer of the appendix. Several things make Wake Forest Baptist the leader in this area. First, we have substantial expertise in the area. We also have four surgeons who are committed to doing these procedures on a regular basis and have been through a learning curve. Additionally, as part of a large comprehensive cancer center, we are able to bring substantial resources to bear for these patients which frequently bring us complex surgical challenges.