Adjuvant Intraperitoneal Chemotherapy for Advanced Primary Gastric Cancer
Adjuvant Intraperitoneal Chemotherapy for Advanced Primary Gastric Cancer
复制标题
晚期原发性胃癌的辅助腹腔化疗
DOI：
10.1177/145749690609500410
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发表时间：
2006
影响因子：
2.4
通讯作者：
P. Sugarbaker
中科院分区：
文献类型：
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作者：
P. Sugarbaker
背景：胃癌向腹膜腔扩散是其自然病史的很大一部分。此外，肿瘤切除后的创伤所引起的肿瘤扩散可将活的癌细胞释放到游离的腹膜腔内；这些细胞植入腹膜后发展为腹膜癌病。方法：从医学文献中对胃癌辅助治疗的结果进行综述和批判性分析。寻求将腹膜内化疗与进展期原发胃癌治疗相结合的外科基础。结果：为将腹腔化疗的细胞毒作用应用于胃癌的早期治疗提供了理论依据。大量的文献表明，围手术期的腹膜内化疗增加了发病率和死亡率，但增加的并发症是可控的。这些数据表明，对于完全切除但局部区域复发可能性很高的胃癌患者，腹膜内化疗在辅助环境下是有益的。摘要：晚期原发胃癌的辅助腹膜内化疗有很强的理论基础。许多报告都证明了这一点。通过教育，通过更多的临床试验，以及通过世界各地腹膜表面恶性肿瘤治疗中心的持续出版物，这种治疗方式的更广泛应用是必要的。
Background: For gastric cancer dissemination to the peritoneal cavity is a large part of the natural history. Also, cancer dissemination caused from the trauma of cancer resection can release viable cancer cells into the free peritoneal cavity; these cells implant and then progress as peritoneal carcinomatosis. Methods: From the medical literature a compilation of the results of adjuvant treatment of gastric cancer were reviewed and critically analyzed. A surgical rationale for integrating intraperitoneal chemotherapy into the management of advanced primary gastric cancer was sought. Results: A theoretical basis for the application of cytotoxic effects of cancer chemotherapy within the peritoneal cavity as a part of the primary management of gastric cancer was explored. Numerous manuscripts suggested that there was an increased morbidity and mortality with perioperative intraperitoneal chemotherapy but the added number of complications was manageable. These data suggest that intraperitoneal chemotherapy is of benefit in an adjuvant setting in gastric cancer patients who have a complete resection but who are at high likelihood of local-regional recurrence. Summary: Adjuvant intraperitoneal chemotherapy for advanced primary gastric cancer has a strong rationale. Numerous reports have established benefit. Wider application of this treatment modality is necessary through education, through additional clinical trials, and through continued publications from peritoneal surface malignancy treatment centers around the world.