Extensive cytoreductive surgery followed by intra-operative hyperthermic intraperitoneal chemotherapy with mitomycin-C in patients with peritoneal carcinomatosis of colorectal origin
Extensive cytoreductive surgery followed by intra-operative hyperthermic intraperitoneal chemotherapy with mitomycin-C in patients with peritoneal carcinomatosis of colorectal origin
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DOI：
10.1016/s0959-8049(01)00058-2
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发表时间：
2001-05-01
影响因子：
8.4
通讯作者：
Zoetmulder, FAN
中科院分区：
文献类型：
--
作者：
Witkamp, AJ;de Bree, E;Zoetmulder, FAN
结直肠癌腹膜种植的预后非常差，并且对全身化疗相对抵抗。我们进行了一项I/II期试验，以调查这些患者中广泛的细胞减灭术联合术中温热腹腔内化疗（HIPEC）的可行性和有效性。29例无远处转移证据的结直肠腹膜癌转移患者接受了细胞减灭术和术中使用丝裂霉素C（MMC）的HIPEC，随后使用5-氟尿嘧啶（5-FU）/甲酰四氢叶酸进行全身化疗。11例患者（38%）发生手术并发症。1例患者死亡与治疗直接相关。导致3%的死亡率MMC毒性反应主要为白细胞减少（15例，占52%）。中位随访38个月（范围26 - 52个月）后，我们发现2年和3年生存率（Kaplan-Meier）分别为45%和23%。广泛的细胞减灭术和HIPEC是可行的腹膜种植结直肠癌患者。初步结果表明，与传统的姑息手术和全身化疗相比，可以实现更高的中位生存率，因此目前正在进行一项随机III期研究。(C)2001爱思唯尔科技有限公司版权所有。
Peritoneal seeding from colorectal cancer has a very poor prognosis and is relatively resistant to systemic chemotherapy. We performed a phase I/II trial to investigate the feasibility and effectiveness of extensive cytoreductive surgery in combination with intra-operative hyperthermic intraperitoneal chemotherapy (HIPEC) in these patients. 29 patients with peritoneal carcinomatosis of colorectal origin without evidence of distant metastases underwent cytoreductive surgery and intra-operative HIPEC with mitomycin-C (MMC), followed by systemic chemotherapy with 5-fluorouracil (5-FU)/leucovorin. Surgical complications occurred in 11 patients (38%). One patient died directly related to the treatment. resulting in a mortality rate of 3%. MMC toxicity existed mainly of leucocytopenia (in 15 patients: 52%). After a median follow-up of 38 months (range 26-52 months) we found a 2- and 3-year survival rate (Kaplan-Meier) of 45 and 23%, respectively. Extensive cytoreductive surgery and HIPEC is feasible in patients with peritoneal seeding of colorectal cancer. First results suggest that a higher median survival could be achieved compared with conventional palliative surgery and systemic chemotherapy, therefore a randomised phase III study is now being conducted. (C) 2001 Elsevier Science Ltd. All rights reserved.