Cagol P P, Pasqual E, Bacchetti S
Department of Surgical Sciences, Surgical Unit of Semeiotica Chirurgica, University of Udine, Udine, Italy.
J Exp Clin Cancer Res. 2003 Dec;22(4 Suppl):1-4.
A great number of locoregional treatments are currently carried out to treat a variety of locoregional neoplastic diseases. Indications are the treatment of primary and metastatic liver tumors, peritoneal mesotheliomas, peritoneal spread of ovarian carcinomas, peritoneal recurrences of gastrointestinal cancers, peritoneal spread of retroperitoneal sarcomas, melanomas and sarcomas of the limbs, some primary tumors of the brain, breast, kidney, lung, bladder. But to deal with locoregional therapy demands to clarify some features of these malignancies. At this regard, the knowing of their natural history can be crucial to guide the choice of the correct locoregional treatment. For instance peritoneal carcinomatosis is considered as a main step of disease progression for ovarian cancer and often for gastrointestinal tumors as well. However when the tumors are confined on the surface of the peritoneum, basing on their own natural history, they can be considered as localized diseases. Selected patients with peritoneal neoplastic seeding, previously considered in a preterminal condition, can be considered as candidates for curative treatment, using cytoreductive surgical tecniques (16) and hyperthermic intraperitoneal chemotherapy (19). The same can be thought about others primary or metastatatic tumors when the neoplastic deposits are confined within a definite site or region of the body. In this paper the main aspects of liver metastases and peritoneal carcinomatosis natural history, two of the most frequently recognized indications for locoregional therapy, are presented.
目前，大量的局部区域治疗被用于治疗各种局部区域肿瘤性疾病。其适应症包括原发性和转移性肝肿瘤、腹膜间皮瘤、卵巢癌的腹膜播散、胃肠道癌的腹膜复发、腹膜后肉瘤的腹膜播散、肢体黑色素瘤和肉瘤、一些原发性脑肿瘤、乳腺癌、肾癌、肺癌、膀胱癌。但是，要进行局部区域治疗，需要明确这些恶性肿瘤的一些特征。在这方面，了解它们的自然病史对于指导正确选择局部区域治疗可能至关重要。例如，腹膜癌病被认为是卵巢癌以及通常也是胃肠道肿瘤疾病进展的一个主要阶段。然而，当肿瘤局限于腹膜表面时，根据其自身的自然病史，它们可被视为局限性疾病。一些先前被认为处于终末期的腹膜肿瘤播散患者，使用细胞减灭术（16）和腹腔内热化疗（19），可被视为根治性治疗的候选者。当肿瘤沉积物局限于身体的特定部位或区域时，对于其他原发性或转移性肿瘤也可作同样考虑。本文介绍了肝转移和腹膜癌病自然病史的主要方面，这是局部区域治疗最常见的两种适应症。
