Knorr C, Reingruber B, Meyer T, Hohenberger W, Stremmel C
Department of Surgery, University of Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany.
Int J Colorectal Dis. 2004 May;19(3):181-7. doi: 10.1007/s00384-003-0524-x. Epub 2003 Aug 29.
Intraperitoneal carcinomatosis accounts for 25-35% of recurrences of colorectal cancer. Studies demonstrate that peritoneal carcinomatosis is not necessarily a terminal condition with no options for treatment or cure.
The combination of aggressive cytoreductive surgery and intra-abdominal hyperthermia chemotherapy improves long-term overall survival in selected patients but is a time-consuming procedure (approx. 12 h) and entails high mortality (5%) and morbidity (35%)). Most commonly used drugs are mitomycin C and platinum compounds, which have synergistic toxic effects on tumor cells when hyperthermia is applied.
Since combined treatment seems promising only in peritoneal carcinomatosis stages I and II, the precondition for a reasonable combined treatment is careful staging. The mode of chemotherapy, the kind of drugs used for chemoperfusion, the timing of surgery, and the role of additional systemic chemotherapy must be evaluated in randomized studies.
腹膜癌转移占结直肠癌复发的25% - 35%。研究表明，腹膜癌转移不一定是无治疗或治愈选择的终末期疾病。
积极的细胞减灭术与腹腔内热化疗相结合可提高部分患者的长期总生存率，但该手术耗时较长（约12小时），且死亡率高（5%）、发病率高（35%）。最常用的药物是丝裂霉素C和铂类化合物，热疗时它们对肿瘤细胞具有协同毒性作用。
由于联合治疗似乎仅在腹膜癌转移I期和II期有前景，合理联合治疗的前提是仔细分期。化疗方式、用于化学灌注的药物种类、手术时机以及额外全身化疗的作用必须在随机研究中进行评估。
