细胞减灭术加腹腔热灌注化疗治疗腹膜种植瘤的研究进展

被引:21
作者
李雁
杨国梁
杨肖军
机构
[1] 武汉大学中南医院、武汉大学肿瘤防治研究中心
关键词
腹膜种植瘤; 细胞减灭术; 腹腔热灌注化疗;
D O I
暂无
中图分类号
R735.5 [腹膜及膜壁肿瘤];
学科分类号
100112 [医学生物化学与分子生物学];
摘要
腹盆腔肿瘤局部进展所导致的腹膜种植瘤是致命性病变,传统治疗方法的效果非常有限,国际上近年来把细胞减灭术加腹腔热灌注化疗作为新治疗模式,作者分析这方面的研究进展。文献检索分析腹膜种植瘤的发病率,病理生理学基础,药物治疗学基础,介绍细胞减灭术加腹腔热灌注化疗治疗各类腹膜种植瘤的临床试验结果。胃癌、结直肠癌、卵巢癌、腹膜间皮瘤、腹膜假黏液瘤、腹腔肉瘤都可形成腹膜种植瘤,常规化疗的中位生存期约6个月。术中腹腔内热灌注化疗可使腹腔内药物浓度比血液内高10~1000倍,温热与化疗有协同抗肿瘤作用。腹膜种植瘤指数是判断癌症腹膜播散程度的客观标准,最大程度细胞减灭术加腹腔内热灌注化疗能显著延长病人的中位生存期:结直肠癌可达到20个月,胃癌达10个月,卵巢癌达65个月,围手术期病残率约27~56%、死亡率0~11%。大多数为Ⅱ期临床研究,Ⅲ期随机分组临床试验较少。细胞减灭术加腹腔热灌注化疗是目前治疗腹膜种植瘤的最有效方法,需要前瞻性多中心随机分组临床试验,以进一步优化技术,提高疗效。
引用
收藏
页码:1257 / 1260
页数:4
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