[一个理论来治愈从低度尾粘性瘤腹膜转移的治疗方法]
Yutaka Yonemura1, Shintarou Shigesato, Haruaki Ishibashi
1Asian School of Peritoneal Surface Malignancy Treatment, Dept. of Regional Cancer Therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Dept. of Regional Cancer Therapy, Peritoneal Dissemination Center, Kusatsu General Hospital.
Gan to kagaku ryoho. Cancer & chemotherapy
|January 17, 2026
概括
综合性治疗,包括完整的细胞还原性手术 (CRS) 和高热性腹膜内化学疗法 (HIPEC),改善了低度膜癌腹膜瘤 (LGMCP) 的治愈率. 新辅助性腹腔内化学疗法 (NIPC) 通过减少微转移负担,进一步提高了结果.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠道手术 胃肠道手术
背景情况:
- 由尾粘膜瘤 (AMN) 产生的腹腔转移 (PM) 是一个治疗挑战.
- 综合治疗 (COMPT),包括完整的细胞削减手术 (CRS) 和术后化疗,旨在治愈PM患者.
- 了解微转移 (MM) 的作用对于优化治疗策略至关重要.
研究的目的:
- 提出使用COMPT从AMN中治愈低度粘膜周周癌 (LGMCP) 的理论基础.
- 评估不同治疗方式的有效性,包括CRS,HIPEC,新辅助化疗 (NAC) 和新辅助腹腔内化疗 (NIPC),以实现治愈.
- 分析影响治愈率和患者存活率的因素.
主要方法:
- 在2009年至2023年期间接受了CRS (CCR-0) 的509名来自AMN的LGMCP患者的回顾性分析.
- 对接受新辅助腹腔镜HIPEC (NLHIPEC) 和CRS (n=142) 和新辅助全身化疗 (NSC) 随后接受NIPC (n=101) 的患者进行亚组分析.
- 基于治疗策略的治愈率的比较:单独CRS,CRS + HIPEC,NIPC + CRS,以及NSC + NIPC.
主要成果:
- 在CCR-0后的5年和10年整体生存率分别为88.7%和77.6%.
- 与CRS单独 (43.2%) 相比,CRS + HIPEC (54.3%) 和NIPC + CRS (53.5%) 的治愈率更高.
- 与NSC相比,NIPC与腹癌指数 (PCI) 较低有关,这表明瘤负担减少.
结论:
- 结合HIPEC和NIPC的完整细胞削减手术 (CCR-0) 可以显著提高LGMCP的治愈率.
- 改善的结果归因于HIPEC消除了微转移 (MM),NIPC减少了MM负担.
- 需要进一步的研究,以制定更有效的MM消除策略.
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