Jakesz R
I. Chirurgischen Universitätsklinik Wien.
Wien Med Wochenschr. 1990 Apr 30;140(8):199-202.
Intraperitoneal chemotherapy for prophylaxis and treatment of peritoneal carcinosis is a new treatment modality. Due to a very difficult definition of remission for peritoneal carcinosis, results of this treatment modality are difficult to state. The total remission rates are currently between 30 and 50% in minimal residual disease. The major advantage of intraperitoneal chemotherapy is the augmentation of the local concentration of the cytotoxic agent which exceeds the serum level in some cases by a factor of 1000. Due to totally implantable systems the high risk of infection in patients with Tenckhoff catheters could be reduced to nearly zero. After perfusion of the peritoneal cavity with a cytotoxic agent the concentration in the portal vein can exceed that in the peripheral blood by a factor of 10. Results of two adjuvant trials could not show a survival benefit of treated patients, however the incidence of peritoneal carcinosis was significantly decreased. New treatment options are a perfusion of the peritoneal cavity with effective cytotoxic drugs in the very early postoperative time period. The combined treatment of cytostatics and "biological response modifiers" could further increase the effectiveness of this treatment modality.
腹腔内化疗用于预防和治疗腹膜癌是一种新的治疗方式。由于腹膜癌缓解的定义非常困难，这种治疗方式的结果难以阐述。在微小残留病中，目前的总缓解率在30%至50%之间。腹腔内化疗的主要优势在于可提高细胞毒性药物的局部浓度，在某些情况下该浓度超过血清水平达1000倍。由于采用完全可植入系统，带Tenckhoff导管患者的高感染风险可降至几乎为零。用细胞毒性药物灌注腹腔后，门静脉中的浓度可比外周血中的浓度高10倍。两项辅助试验的结果未显示治疗患者有生存获益，然而腹膜癌的发生率显著降低。新的治疗选择是在术后极早期用有效的细胞毒性药物灌注腹腔。细胞抑制剂与“生物反应调节剂”的联合治疗可能会进一步提高这种治疗方式的有效性。
