Feasibility and safety of hyperthermic intraperitoneal chemotherapy using 5-fluorouracil combined with cisplatin and mitomycin C in patients undergoing gastrectomy for advanced gastric cancer
Feasibility and safety of hyperthermic intraperitoneal chemotherapy using 5-fluorouracil combined with cisplatin and mitomycin C in patients undergoing gastrectomy for advanced gastric cancer
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5-氟尿嘧啶联合顺铂和丝裂霉素C腹腔热化疗治疗进展期胃癌胃切除术的可行性和安全性
DOI：
10.1002/jso.24771
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发表时间：
2017
影响因子：
2.5
通讯作者：
Tani Masaji
中科院分区：
文献类型：
--
作者：
Murata Satoshi;Yamamoto Hiroshi;Naitoh Hiroyuki;Yamaguchi Tsuyoshi;Kaida Sachiko;Shimizu Tomoharu;Shiomi Hisanori;Naka Shigeyuki;Tani Tohru;Tani Masaji
背景与目的为探索晚期胃癌（GC）腹腔温热化疗（HIPEC）的剂量范围，我们对5-氟尿嘧啶（5-FU）联合顺铂（CDDP）和丝裂霉素C（MMC）进行了研究（200 µg/mL）、MMC（2 µg/mL）和CDDP（10 µg/mL）在高温条件（42 ℃）下孵育30 min。这是一项临床研究，以确定推荐剂量的5-FU与MMC和CDDP在42°C下30分钟的组合，并评估HIPEC在GC手术后发生腹膜转移的高风险患者中的安全性。1000 mg与MMC（10 mg）、CDDP（50 mg）联合灌流5 L。直到达到1000 mg 5-FU时才出现剂量限制性毒性。4例患者发生1级或2级不良事件。推荐剂量为1000 mg 5-FU/5 L灌注液。8例（66.7%）患者术后无腹膜转移，5年生存率为83.3%。结论胃癌根治术联合HIPEC联合MMC、CDDP、5-FU治疗晚期胃癌是安全可行的，可有效预防胃癌术后腹膜转移。
Background and ObjectivesWe conducted a dose‐finding study for 5‐fluorouracil (5‐FU) administered with cisplatin (CDDP) and mitomycin C (MMC) to find an improved regimen for hyperthermic intraperitoneal chemotherapy (HIPEC) for advanced gastric cancer (GC).MethodsThe appropriate HIPEC regimen previously determined in vitro was 5‐FU (200 µg/mL), MMC (2 µg/mL), and CDDP (10 µg/mL) at hyperthermic conditions (42°C) for 30 min. This was a clinical study to determine the recommended dose of 5‐FU in combination with MMC and CDDP at 42°C for 30 min and to evaluate HIPEC safety in patients at high risk of developing peritoneal metastases following GC surgery.ResultsTwelve patients were treated with surgery plus HIPEC using 5‐FU at 0, 500, 750, and 1000 mg combined with MMC (10 mg) and CDDP (50 mg) in the perfusate (5 L). Dose‐limiting toxicities did not develop until 1000 mg 5‐FU was reached. Four patients experienced grade 1 or 2 adverse events. The recommended dose was 1000 mg 5‐FU/5 L perfusate. Eight (66.7%) patients demonstrated no recurrence of peritoneal metastases; 5‐year overall survival rate was 83.3%.ConclusionGastrectomy and HIPEC with MMC, CDDP, and 5‐FU is feasible, safe, and may protect against peritoneal metastasis following surgery for advanced GC.