腹腔内化疗在结直肠癌腹膜转移中的应用

Intraperitoneal chemotherapy for colorectal cancer peritoneal metastasis

腹膜转移是结直肠癌常见的转移部位之一,且预后差。结直肠癌腹膜转移的核心治疗策略是以肿瘤细胞减灭术及全身系统化疗为主,腹腔内化疗为辅的综合治疗技术。作为治疗的重要补充,腹腔内化疗具有广阔的应用前景,其模式主要有腹腔内热灌注化疗、新辅助腹腔内化疗联合全身化疗、术后早期腹腔内化疗、术后序贯腹腔内化疗、常温腹腔内化疗及加压气溶胶腹腔内化疗等。目前需要进一步研究结直肠癌腹膜转移的机制,选择有效的腹腔内化疗药物及用药时机、给药模式,探索序贯腹腔内化疗的可行性,进行有价值的基础和临床研究,从而推动腹腔内化疗的规范化开展。本文将综述腹腔内化疗的起源发展、治疗方式及其在结直肠癌腹膜转移中的应用现状和前景。

Peritoneal metastasis is one of the common site of colorectal cancer metastasis and associated with a poor prognosis.The core strategy for colorectal cancer peritoneal metastasis primarily revolves around a comprehensive treatment approach with cytoreductive surgery and systemic chemotherapy as the mainstay,supplemented by intraperitoneal chemotherapy.As an important supplement to treatment,intraperitoneal chemotherapy has broad application prospects.The main modalities are hyperthermic intraperitoneal chemotherapy(HIPEC),neoadjuvant intraperitoneal and systemic chemotherapy(NIPS),early postoperative intraperitoneal chemotherapy(EPIC),sequential postoperative intraperitoneal chemotherapy(SPIC),normothermic intraperitoneal chemotherapy(NIPEC)and pressurized intraperitoneal aerosol chemotherapy(PIPAC).To promote the standardized application of intraperitoneal chemotherapy,further research on the mechanisms underlying peritoneal metastasis of colorectal cancer,selection of effective intraperitoneal chemotherapy agents,determination of optimal timing and administration protocols,exploration of the feasibility of sequential intraperitoneal chemotherapy and conduction of valuable basic and clinical research are currently needed.This paper will review the development and origins of intraperitoneal chemotherapy,treatment modalities,as well as the current application status and prospects of various treatment approaches in the context of peritoneal metastasis of colorectal cancer.