控制输液温度与细胞还原性手术和高温腹腔内化疗后的更好的结果有关
Felipe Lopez-Ramirez1, Kseniia Uzhegova1, Mary Caitlin King1
1Mercy Medical Center, The Institute for Cancer Care, Department of Surgical Oncology, 227 St. Paul Place, Weinberg Building, 4th Floor, Baltimore, MD, 21202-2001, USA.
概括
在细胞还原性手术和高温腹腔内化疗 (CRS/HIPEC) perfusion 期间保持最佳的热剂量,定义为 ≥40.5°C 在 ≥70% 的时间内,显著改善整体存活率. 精心控制输液温度对于更好的患者结果至关重要.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 化疗 化疗是一种化学疗法.
背景情况:
- 在细胞还原手术和高温腹腔内化疗 (CRS/HIPEC) 期间的温度变化可能会影响治疗疗效.
- 在输液过程中描述最佳热剂量对于改善患者的治疗结果至关重要.
研究的目的:
- 在CRS/HIPEC输液过程中定义最佳热剂量.
- 评估实现最佳热剂量对患者存活率和结果的影响.
主要方法:
- 755名CRS/HIPEC患者 (2004-2024) 的回顾性队列研究,完成了细胞减小 (CC-0/1) 和90分钟的输液.
- 使用最小p值方法确定最佳热剂量:输出温度≥40.5°C,输液时间≥70% (PASS).
- 亚组多变量考克斯回归分析以评估生存效益.
主要成果:
- 70.3%的患者 (n=531) 达到最佳热剂量 (PASS),而29.7% (n=224) 没有 (FAIL).
- 在PASS组中,平均整体存活时间显著较长 (149.4 vs 80.3个月,P < .01).
- 对PASS条件的生存益处观察到mitomycin-C和melphalan,但不是剂;在CC-0和PCI<25小组中也观察到益处.
结论:
- 保持输出温度≥40.5°C≥70%的输液时间与CRS/HIPEC的整体存活率的改善有关.
- 热剂量需要在CRS/HIPEC过程中进行仔细的表征和控制.
- 最佳热剂量的生存益处因化疗剂和患者亚组而异,需要进一步研究.
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