Locoregional treatment of peritoneal carcinomatosis from gastric cancer
Locoregional treatment of peritoneal carcinomatosis from gastric cancer
复制标题
DOI：
10.1002/jso.21052
复制
发表时间：
2008-09-15
影响因子：
2.5
通讯作者：
Deraco, Marcello
中科院分区：
文献类型：
--
作者：
Bozzetti, F.;Yu, W.;Deraco, Marcello
作者简要回顾了胃癌腹膜癌转移的自然史和主要特征，并分析了有关局部区域预防和治疗方法的相关文献。还总结了专家网上投票的结果。关于细胞毒性药物腹腔灌注联合或不联合热疗预防高危患者腹膜癌转移，有一些随机临床试验和一项荟萃分析支持该手术的受益。然而，方法学上的差异（药物、剂量、治疗持续时间、增加热疗等）排除了在高风险患者的临床实践中采用共享方案。一旦。腹膜癌转移已确定，文献报道的方法是腹膜切除术联合热灌注。然而，数据支持的好处是稀缺的，并限于少数中心在这一领域的具体经验。关于向专家小组提出的主要问题以及关于治疗指征和方法的问题。专家们的意见大体一致，并同意文献的结论。专家和作者都认识到需要进行一项大型多中心试验来证实腹腔化疗的获益和风险。
The authors reviewed the natural history and the main features of the peritoneal carcinomatosis from gastric cancer briefly and analyzed the pertinent literature concerning the locoregional modalities for prevention and for treatment. Results of the web based voting by experts were also summarized. As regards the peritoneal perfusion with cytotoxic drugs with or without hyperthermia for preventing peritoneal carcinomatosis in high risk patients, there are some randomized clinical trials and one meta-analysis supporting a benefit of the procedure. However, disparity in methodology (drugs, dosage, duration of the treatment, addition of hyperthermia, etc.) precludes the adoption of a shared protocol to be used in the clinical practice in high risk patients. Once the. peritoneal carcinomatosis is established, the approach reported in literature is the peritonectomy associated with hyperthermic perfusion. However, data supporting benefits are scanty, and limited to few centers with a specific experience in this field. With regard to the main questions addressed to the experts' panel and concerning the indications for treatment and methodology. there was a general consistency among the experts and agreement with the findings of the literature. The need for a large multicenter trial to confirm the benefit and risk of intraperitoneal chemotherapy was recognized by both the experts and the authors.