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Profilaxis con mitomicina adsorbida con carbono contra la recurrencia peritoneal del cáncer gástrico

A Hagiwara¹, T Takahashi, O Kojima

¹First Department of Surgery, Kyoto Prefectural University of Medicine, Japan.

Lancet (London, England)

|March 14, 1992

Resumen

La mitomicina adsorbida en carbón activado (M-CH) mejoró la supervivencia en pacientes con cáncer gástrico al prevenir la carcinomatosis peritoneal. Esta preparación de liberación retardada mantuvo mayores concentraciones de fármaco en la cavidad peritoneal, ofreciendo un tratamiento profiláctico prometedor.

Área de la Ciencia:

Oncología Oncología.
Oncología Quirúrgica Oncología Quirúrgica.
Gastroenterología y Gastroenterología.

Sus antecedentes:

La carcinomatosis peritoneal es un desafío significativo después de la cirugía de cáncer gástrico.
La quimioterapia intraperitoneal ha mostrado un éxito limitado debido a la mala retención del fármaco.
Se necesitan nuevos sistemas de administración de medicamentos para mejorar la eficacia.

Objetivo del estudio:

Evaluar la eficacia profiláctica de la mitomicina adsorbida en el carbón activado (M-CH) contra la carcinomatosis peritoneal.
Para evaluar el impacto de M-CH en la supervivencia del paciente después de la gastrectomía para el cáncer gástrico.

Principales métodos:

Un estudio aleatorizado en el que participaron 50 pacientes con cáncer gástrico con infiltración serosa.
Administración intraperitoneal intraoperatoria de M-CH (50 mg de mitomicina) frente a ninguna profilaxis (grupo de control).
Las tasas de supervivencia y las concentraciones de mitomicina en el líquido peritoneal y el plasma fueron monitoreadas durante 3 años.

Principales resultados:

Se observaron tasas de supervivencia a 3 años significativamente más altas en el grupo M-CH en comparación con el grupo de control (p < 0,01).
Las concentraciones de mitomicina fueron significativamente más altas en el exudado peritoneal que en el plasma durante las 24 horas posteriores a la administración.
El tratamiento con M-CH se asoció con efectos secundarios leves y bien tolerados.

Conclusiones:

La administración peroperativa intraperitoneal de M-CH parece mejorar la supervivencia después de la gastrectomía por cáncer gástrico.
La mejora de la supervivencia se debe probablemente al efecto profiláctico de la M-CH en la recurrencia peritoneal.
M-CH demuestra una retención efectiva del fármaco en la cavidad peritoneal, abordando una limitación clave de las terapias intraperitoneas anteriores.

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