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超热腹腔内化学疗法是否适用于结肠癌?

Nolan M Winicki¹, Jonathan B Greer²

¹Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

Advances in surgery

|August 1, 2024

概括

带有高热性腹腔内化疗 (HIPEC) 的细胞还原性手术可以延长腹腔内转移的结直肠癌 (CRC) 患者的生存期. 然而,基于氧沙的HIPEC不推,而米托米辛C缺乏广泛使用的强有力的支持证据.

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:

结肠直肠癌 (CRC) 与腹转移带来了重大管理挑战.
细胞还原性手术 (CRS) 与高热性腹腔内化疗 (HIPEC) 结合,在经验丰富的中心的精选患者中提供生存益处.
目前CRC中CRS/HIPEC的治疗模式正在发展.

研究的目的:

审查当前的建议和新出现的趋势,对结肠直肠癌与腹膜转移的高热性腹膜内化学疗法.
评估证据支持不同的化疗剂和 perfusion 时间在HIPEC的CRC.

主要方法:

审查最近的随机对照试验和临床证据.
对结直肠癌的CRS/HIPEC现行实践和新兴趋势的分析.

主要成果:

根据最近的试验,不再建议在CRS后使用oxaliplatin与缩短 perfusion (30分钟) 的HIPEC.
有一种趋势是使用米托米辛C与延长 perfusion (90-120分钟) 作为一线药物.
支持在这种情况下广泛使用米托米辛C的前性证据有限.

结论:

结肠直肠癌与腹转移的管理需要仔细选择患者和经验丰富的CRS/HIPEC中心.
不建议使用基于牛利的短 perfusion 的 HIPEC.
需要进一步的前性研究来验证米托米辛C在CRC中延长 perfusion HIPEC的疗效和安全性.

关键词:

结肠直肠癌是一种癌症.细胞还原性手术是指细胞还原性手术.头 - - 一个头.超热内皮管内化学疗法超热内皮管内化学疗法腹腔周周癌症的发生.腹膜转移的发生.

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