新型多模式疗法及其在胃癌中的预后潜力
Swathikan Chidambaram1, Delia Cortés Guiral2, Sheraz Rehan Markar3,4
1Department of Surgery and Cancer, Imperial College London, London W2 1NY, UK.
Cancers
|June 28, 2023
概括
超热性腹腔内化学疗法 (HIPEC) 和压力气溶化学疗法 (PIPAC) 显示,腹腔癌与腹腔癌的存活率有所改善. 完整的细胞减少是改善结果的关键预后因素.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 胃癌经常转移到腹膜 (GC / PC),呈现出不良预后.
- 对GC/PC的最佳治疗方法尚不确定,预后因素尚未纳入指南.
- 本次审查解决了对GC/PC.的更新诊断和治疗策略的需求.
研究的目的:
- 系统地审查和评估GC/PC的诊断和管理的最新进展.
- 在GC/PC患者中评估高热性腹腔内化学疗法 (HIPEC) 和压力气溶化学疗法 (PIPAC) 的疗效.
主要方法:
- 在主要数据库 (MEDLINE,EMBASE,Cochrane,Scopus) 进行了系统的文献审查.
- 分析了针对GC/PC的HIPEC和PIPAC的研究.
- 一项元分析评估了HIPEC的整体存活率 (OS) 和细胞减少程度的预后意义.
主要成果:
- 包括17项研究,分析了2297篇最初识别的文章.
- 与细胞减小手术 (CRS) 结合的HIPEC与单独的CRS相比,显著改善了短期 (1年) 和长期 (5年) 的OS.
- 完整的细胞减少 (腹膜癌症指数<7) 是较长寿命的显著预后因素;PIPAC显示总寿命为10.3个月.
结论:
- HIPEC和PIPAC代表了管理GC/PC的有希望的新型治疗策略.
- 需要进一步的研究来确定这些疗法在治疗算法中的最终作用.
- 识别和验证预后因素将有助于优化患者选择这些先进治疗方法.
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