CONTINUOUS HYPERTHERMIC PERITONEAL PERFUSION FOR THE PREVENTION OF PERITONEAL RECURRENCE OF GASTRIC-CANCER - RANDOMIZED CONTROLLED-STUDY
CONTINUOUS HYPERTHERMIC PERITONEAL PERFUSION FOR THE PREVENTION OF PERITONEAL RECURRENCE OF GASTRIC-CANCER - RANDOMIZED CONTROLLED-STUDY
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DOI：
10.1007/bf00348209
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发表时间：
1994-01-01
影响因子：
2.6
通讯作者：
MIYAZAKI, I
中科院分区：
文献类型：
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作者：
FUJIMURA, T;YONEMURA, Y;MIYAZAKI, I
我们采用持续温热腹腔灌注（CHPP）或持续常温腹腔灌注（CNPP）联合顺铂（CDDP）300 mg/kg和丝裂霉素C（MMC）30 mg/kg预防胃癌术后腹腔复发。在一项随机对照研究中，22名患者使用加热至41 ℃至42 ℃的约10升生理盐水进行灌注治疗（CHPP组）; 18名患者使用加热至37 ℃至38 ℃的生理盐水进行治疗（CNPP组）; 18名患者仅接受胃手术而不进行灌注（对照组）。CHPP组有2例（9%）死于腹膜复发，CNPP组有4例（22%），对照组有4例（22%）。CHPP组的1、2和3年生存率分别为95%、89%和68%; CNPP组分别为81%、75%和51%;对照组分别为43%、23%和23%。三种生存曲线经对数秩检验有显著性差异（p < 0.01）。这种差异表明CNPP和CHPP都是预防腹膜复发的有效方法。在灌注结束时，300 mg给药的总CDDP和游离CDDP的灌注液中的最大浓度分别为12.2和10.1 μ g/ml，血浆中总CDDP和游离CDDP的最大浓度分别为2.1和1.0 μ g/ml。灌注液和血浆中MMC的最大浓度为1.00和0.05 μ g/ml，分别为30 mg给药，这是腹腔内细胞毒性，但全身安全的浓度。
We performed continuous hyperthermic peritoneal perfusion (CHPP) or continuous normothermic peritoneal perfusion (CNPP) combined with cisplatin (CDDP) 300 mg/kg and mitomycin C (MMC) 30 mg/kg in an attempt to prevent peritoneal recurrence after surgery for gastric cancer. Twenty-two patients were treated with perfusion using about 10 liters of saline heated to 41-degrees to 42-degrees-C (CHPP group); 18 patients were treated with saline heated to 37-degrees to 38-degrees-C (CNPP group); and 18 patients underwent only gastric surgery without perfusion (control group) in a randomized control study. There were two deaths (9%) due to peritoneal recurrence in the CHPP group, four (22%) in the CNPP group, and four (22%) in the control group. The 1-, 2-, and 3-year survival rates were 95%, 89%, and 68%, in the CHPP group; 81%, 75%, and 51%, in the CNPP group; and 43%, 23%, and 23%, in the control group, respectively. There was a significant difference between the three survival curves by the log-rank test (p < 0.01). This difference showed that CNPP and CHPP are both effective procedures for preventing peritoneal recurrence. The maximum concentrations in the perfusate of total and free CDDP with 300 mg administration were 12.2 and 10.1 mug/ml, respectively, at the end of the perfusion, and the maximum concentrations of total and free CDDP in plasma were 2.1 and 1.0 mug/ml, respectively. The maximum concentrations of MMC in perfusate and plasma with 30 mg administration were 1.00 and 0.05 mug/ml, respectively, which are intraperitoneally cytotoxic but systemically safe concentrations.