国际腹膜癌治疗指南:肿瘤细胞减灭术加腹腔化疗临床路径

International guidelines for the treatment of peritoneal cancer:clinical pathways of cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy

腹膜癌是一种预后较差的恶性肿瘤,肿瘤来源较广泛,开展规范化治疗对腹膜癌患者至关重要。腹膜表面肿瘤协作组国际联盟(Peritoneal Surface Oncology Group International,PSOGI)制订了腹膜癌临床指南,本文为国际腹膜癌治疗指南中文版,该指南共分四部分:术前评估、腹膜癌手术、腹膜癌化疗及临床路径。其中,术前评估主要包括术前CT检查、预后评估模型、诊断性腹腔镜探查、腹膜癌指数及细胞减灭程度评分;腹膜癌治疗原则是以肿瘤细胞减灭术(cytoreductive surgery,CRS)和围手术期化疗为核心的综合治疗,但完全CRS是患者获得长期生存的关键;腹膜癌化疗主要包括围手术期化疗及区域性化疗。最后,本指南概述了腹膜癌的临床路径。经PSOGI执行委员会秘书长许可,发表该指南中文版。

Peritoneal cancer originates from a wide range of tumor sources and is associated with poor prognosis.Standardized therapy is of great significance in the treatment for patients with peritoneal cancer.The Peritoneal Surface Oncology Group International(PSOGI)instituted guidelines for peritoneal metastases.This article uses the Chinese version,which is divided into four parts:preoperative evaluation,surgery,chemotherapy,and clinical pathway.The preoperative evaluation consists of preoperative computed tomography,prognostic evaluation model,diagnostic laparoscopic exploration,the peritoneal cancer index,and the cytoreduction score.Peritoneal cancer treatment primarily consists of comprehensive treatment with cytoreductive surgery(CRS)and intraperitoneal hyperthermic chemotherapy.However,complete CRS is the key to the long-term survival of patients.Peritoneal cancer chemotherapy generally includes perioperative chemotherapy and regional chemotherapy.Finally,this guide outlines the clinical pathways.The Chinese version of the guidelines was published under the permission of the Secretary-General of the PSOGI Executive Committee.