Cytoreductive surgery and perioperative intraperitoneal chemotherapy for the treatment of advanced primary and recurrent ovarian cancer
Cytoreductive surgery and perioperative intraperitoneal chemotherapy for the treatment of advanced primary and recurrent ovarian cancer
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DOI：
10.1097/gco.0b013e32831f8f32
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发表时间：
2009-02-01
影响因子：
2.1
通讯作者：
Sugarbaker, Paul H.
中科院分区：
文献类型：
--
作者：
Sugarbaker, Paul H.
综述目的卵巢癌在美国和世界范围内的发病率稳定，仍然是妇科恶性肿瘤死亡的头号原因。晚期卵巢恶性肿瘤的常规治疗方法是手术切除和全身化疗。超过50%的患者在5年内复发。对于晚期原发性和复发性疾病，基于其他腹膜表面恶性肿瘤的经验，建议采用包括细胞减少手术和围手术期腹腔内化疗在内的综合方法。这些治疗的目标是手术根除所有可见的肿瘤和化学和物理根除微观残留疾病。细胞减少手术包括腹膜切除术和内脏切除术。在华盛顿癌症研究所，顺铂和阿霉素在手术过程中通过腹腔加热给药。术后前5天，患者接受恒温腹腔注射紫杉醇。采用这种综合方法的几个II期试验结果表明，与历史对照相比，生存率提高，发病率和死亡率合理。
Purpose of reviewWith a steady incidence in the United States and worldwide, ovarian cancer remains the number one cause of death from gynecological malignancies. The conventional treatment approach for advanced ovarian malignancy is surgical debulking and systemic chemotherapy. More than 50% of these patients relapse within 5 years.Recent findingsFor advanced primary and recurrent disease, a comprehensive approach including cytoreductive surgery and perioperative intraperitoneal chemotherapy, based on the experience with other peritoneal surface malignancies is proposed. The goal of these treatments is to surgically eradicate all visible tumor and to chemically and physically eradicate microscopic residual disease. Cytoreductive surgery includes peritonectomy procedures and visceral resections. At the Washington Cancer Institute, cisplatin and doxorubicin are administered through the intraperitoneal route with heat during the surgical procedure. In the first 5 postoperative days, patients receive normothermic intraperitoneal paclitaxel.SummaryResults of several phase II trials with this comprehensive approach suggested improved survival as compared with historical controls with reasonable morbidity and mortality.