细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜癌的系统分析

Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy on Gastric Cancer Peritoneal Carcinomatosis: A Systemic Analysis

目的系统分析肿瘤细胞减灭术(cytoreductive surgery,CRS)加腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)治疗胃癌腹膜癌(gastric cancer peritoneal carcinomatosis,GC PC)的应用现状及发展方向。方法检索CRS+HIPEC治疗GC PC相关临床研究文献,提取生存及安全性相关数据,进行系统分析。结果 GC PC的自然病程不超过5月,CRS+HIPEC可延长GC PC患者总生存期(overall survival,OS)。在前瞻性临床研究中CRS+HIPEC组中位OS为11.0月,在回顾性临床研究中CRS+HIPEC组中位OS为13.3月。CRS+HIPEC治疗GC PC围手术期死亡率低于6.5%,严重不良事件发生率无显著上升。结论 CRS+HIPEC治疗GC PC疗效显著,有望成为部分经选择的GC PC患者的首选治疗。

Objective To evaluate the clinical trials of cytoreductive surgery （CRS） plus hyperthermic intraperitoneal chemotherapy （HIPEC） on gastric cancer peritoneal carcinomatosis （GC PC）. Methods The published clinical trials of CRS＋HIPEC on GC PC were critically evaluated, with survival and safety as the primary endpoints. Results The natural course of GC PC was 〈 5 months. CRS＋HIPEC could improve the overall survival （OS）. In prospective studies, the median OS was 11,0 months in the CRS＋HIPEC group. In retrospective studies, the median OS was 13,3 months in the CRS＋HIPEC group. The perioperative mortality was less than 6.5%, and there was no statistically significant increase in serious adverse events directly attributable to CRS＋HIPEC. Conclusion CRS＋HIPEC is a promising integrated treatment strategy for GC PC to produce improved treatment efficacy, and should be recommended as the first treatment choice for selected patients with GC PC.