腹腔加压气溶胶化学治疗在结直肠癌腹膜转移治疗中的研究进展

Pressurized intraperitoneal aerosol chemotherapy in the treatment of peritoneal metastasis from colorectal cancer:research progress

结直肠癌腹膜转移患者预后不佳,首次确诊时往往已处于晚期。人们对结直肠癌腹膜转移的治疗理念已从姑息治疗转变为以系统化学治疗、肿瘤细胞减灭术联合腹腔热灌注化学治疗等的多学科综合疗法。腹腔加压气溶胶化学治疗(PIPAC)以一种新型腹腔内给药方式被用来治疗不可切除的腹膜转移癌患者,较既往治疗手段具有微创、安全、药物分布均质及渗透肿瘤能力强等优点。基于这些优势,其自2011年首次应用于人体以来,已在世界多国使用。研究者还不断改进着PIPAC的技术模式,研发出了多种新治疗模式。本文对PIPAC主要在结直肠癌腹膜转移治疗中的历史、技术规范、并发症、安全性及预后等进行综述。

Patients with peritoneal metastasis from colorectal cancer have poor prognoses and are usually at advanced stage when first diagnosed.We have changed their treatment concepts for peritoneal metastasis of colorectal cancers from traditional palliative treatment to multidisciplinary treatments(including chemotherapy,cytoreductive surgery and hyperthermic intraperitoneal chemotherapy).Pressurized intraperitoneal aerosol chemotherapy(PIPAC)is introduced as a novel intraperitoneal administration approach to treat unresectable peritoneal metastasis from colorectal cancers.Compared with previous treatments,it has the advantages of minimal invasion,good safety,a homogeneous intraperitoneal distribution and enhanced tumour penetration.Owning to these advantages,PIPAC has been used in many countries around the world since its first application in humans in 2011.With increasingly improved technical models of PIPAC,several new treatment models were developed.The article reviews the history,technical criteria,complications,safety and prognosis of PIPAC treatment for peritoneal metastasis from colorectal cancers.