PROPHYLAXIS WITH CARBON-ADSORBED MITOMYCIN AGAINST PERITONEAL RECURRENCE OF GASTRIC-CANCER
PROPHYLAXIS WITH CARBON-ADSORBED MITOMYCIN AGAINST PERITONEAL RECURRENCE OF GASTRIC-CANCER
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DOI：
10.1016/0140-6736(92)90792-2
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发表时间：
1992-03-14
期刊：
影响因子：
168.9
通讯作者：
SAKAKURA, C
中科院分区：
文献类型：
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作者：
HAGIWARA, A;TAKAHASHI, T;SAKAKURA, C
通过腹膜内施用抗癌药物来预防胃癌手术后腹膜癌转移的尝试尚未成功，主要是因为药物未保留在腹膜腔中。我们评估了一种缓释制剂丝裂霉素吸附到活性炭（M-CH）的预防效果。50例胃癌和浆膜浸润患者随机分配腹腔内治疗M-CH（50 mg丝裂霉素术中）或无抗癌预防（对照）。24例M-CH受者（1例失访）的3年随访生存率显著高于25例对照组（p < 0.01）。随机分组后1.5年（差异34.6% [95%置信区间8.5-60.8%]; p < 0.01）和2.0、2.5和3.0年（41.7% [14.2-69.1%]; p < 0.005）时，两组的生存率存在显著差异。给药后24 h，腹腔渗出液中丝裂霉素的浓度显著高于血浆。副作用轻微，耐受性良好。因此，围手术期腹腔内治疗M-CH似乎提高胃癌胃切除术后的生存率，大概是通过预防腹膜复发的作用。
Attempts to prevent peritoneal carcinomatosis after surgery for gastric cancer by intraperitoneal administration of anticancer drugs have not been successful, largely because the drugs are not retained in the peritoneal cavity. We have assessed the prophylactic efficacy of a delayed-release preparation mitomycin adsorbed onto activated charcoal (M-CH).50 patients with gastric cancer and serosal infiltration were randomly assigned intraperitoneal treatment with M-CH (50 mg mitomycin intraoperatively) or no anticancer prophylaxis (control). Survival rates for the 3 years of follow-up were significantly higher among the 24 M-CH recipients (1 was lost to follow-up) than among the 25 controls (p < 0.01). There were significant differences in survival between the groups at 1.5 years after randomisation (difference 34.6% [95% confidence interval 8.5-60.8%]; p < 0.01) and at 2.0, 2.5, and 3.0 years (41.7% [14.2-69.1%]; p < 0.005). The concentration of mitomycin was significantly higher in peritoneal exudate than in plasma for 24 h after drug administration. Side-effects were slight and well tolerated.Thus, peroperative intraperitoneal treatment with M-CH seems to improve survival after gastrectomy for gastric cancer, presumably by a prophylactic effect on peritoneal recurrence.