德国胃癌腹膜转移腹腔热灌注化疗的实践和进展

Practice and progress in the treatment of peritoneal metastases of gastric cancer in Germany

本文系统介绍了德国胃癌腹膜转移治疗和预防方面的临床试验结果和治疗经验。肿瘤细胞减灭术(cytoreductive surgery,CRS)联合腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)和(或)胃切除术可以在有潜在治愈性的情况下实施,但仅能在经验丰富的中心并根据多学科诊疗团队的临床决策开展。目前,德国正在进行有关CRS+HIPEC治疗胃癌腹膜转移的有效性和安全性的高质量临床试验,也进行着有关胃癌切除术后辅助HIPEC治疗的临床试验。德国发明的加压腹腔气溶胶化疗(pressurized intraperitoneal aerosol chemotherapy,PIPAC)技术联合系统性化疗可作为姑息性治疗手段处理及预防腹水等并发症,期待有更多临床研究结果证实其有效性。

This paper systematically reviewed the evidence and experience in the treatment and prevention of gastric cancerperitoneal metastasis(GCPM) in Germany. Cytoreductive surgery(CRS) combined with hyperthermic intraperitoneal chemotherapy(HIPEC) and/or gastrectomy can be performed with curative intent, and it should be performed only in experienced centers according to multiple discipline treatment decision. Several trails have been ongoing in Germany regarding the efficacy and safety of CRS +HIPEC for the treatment and prevention of GCPM. Pressurized intraperitoneal aerosol chemotherapy(PIPAC) invented by Germany combined with systemic chemotherapy have also been used as a palliative treatment for ascites. Although ongoing trials have shown encouraging results, more clinical studies are warranted to confirm its effectiveness.