Veno-venous perfusion-induced systemic hyperthermia: case report with perfusion considerations

Cancer cells are more susceptible to destruction by heat than are their nor mal counterparts. However, optimization of this hyperthermic susceptibility for selective cancer cell kill has been difficult to define and technicall y difficult to achieve. A whole-body hyperthermic technique veno-venous per fusion-induced systemic hyperthermia (VV-PISH) was designed in in vitro and in swine experiments to achieve selective hyperthermic cancer cell destruc tion. In this case report, VV-PISH is studied for its safety and therapeuti c efficiency in a Food and Drug Administration (FDA) approved phase-I study , where hyperthermia is used to treat advanced (Stage III B or IV) lung can cer. VV-PISH, utilizing the ThermoChem(TM) HT system in an extracorporeal circui t, was used to induce hyperthermia to 42.5 degreesC sustained for 120 min. Cooling returned the body temperature to 37 degreesC. After completion of t he treatment, the patient was transferred to the intensive care unit on a v entilator, norepinephrine and diuretics. The patient remained somnolent for 36 h, developed pulmonary congestion requiring an additional 48 h before e xtubation, was transferred to the intermediate unit on day 4 and discharged in good condition on day 8. He did experience hyperthermia-related shrinka ge of his lung cancer; however, he succumbed 270 days after this treatment from further progression of this disease.