Turaga K, Levine E, Barone R, Sticca R, Petrelli N, Lambert L, Nash G, Morse M, Adbel-Misih R, Alexander H R, Attiyeh F, Bartlett D, Bastidas A, Blazer T, Chu Q, Chung K, Dominguez-Parra L, Espat N J, Foster J, Fournier K, Garcia R, Goodman M, Hanna N, Harrison L, Hoefer R, Holtzman M, Kane J, Labow D, Li B, Lowy A, Mansfield P, Ong E, Pameijer C, Pingpank J, Quinones M, Royal R, Salti G, Sardi A, Shen P, Skitzki J, Spellman J, Stewart J, Esquivel J
Medical College of Wisconsin, Milwaukee, WI, USA.
Ann Surg Oncol. 2014 May;21(5):1501-5. doi: 10.1245/s10434-013-3061-z. Epub 2013 Jun 21.
The American Society of Peritoneal Surface Malignancies (ASPSM) is a consortium of cancer centers performing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). This is a position paper from the ASPSM on the standardization of the delivery of HIPEC.
A survey was conducted of all cancer centers performing HIPEC in the United States. We attempted to obtain consensus by the modified method of Delphi on seven key HIPEC parameters: (1) method, (2) inflow temperature, (3) perfusate volume, (4) drug, (5) dosage, (6) timing of drug delivery, and (7) total perfusion time. Statistical analysis was performed using nonparametric tests.
Response rates for ASPSM members (n = 45) and non-ASPSM members (n = 24) were 89 and 33 %, respectively. Of the responders from ASPSM members, 95 % agreed with implementing the proposal. Majority of the surgical oncologists favored the closed method of delivery with a standardized dual dose of mitomycin for a 90-min chemoperfusion for patients undergoing cytoreductive surgery for peritoneal carcinomatosis of colorectal origin.
This recommendation on a standardized delivery of HIPEC in patients with colorectal cancer represents an important first step in enhancing research in this field. Studies directed at maximizing the efficacy of each of the seven key elements will need to follow.
美国腹膜表面恶性肿瘤协会（ASPSM）是一个由进行细胞减灭术联合腹腔内热灌注化疗（HIPEC）的癌症中心组成的联盟。这是ASPSM关于HIPEC实施标准化的立场文件。
对美国所有开展HIPEC的癌症中心进行了一项调查。我们试图通过改良的德尔菲法就七个关键的HIPEC参数达成共识：（1）方法，（2）流入温度，（3）灌注液体积，（4）药物，（5）剂量，（6）给药时间，以及（7）总灌注时间。使用非参数检验进行统计分析。
ASPSM成员（n = 45）和非ASPSM成员（n = 24）的回复率分别为89%和33%。在ASPSM成员的回复者中，95%同意实施该提议。大多数外科肿瘤学家倾向于采用封闭给药方法，对因结直肠癌腹膜转移而接受细胞减灭术的患者进行90分钟化疗灌注时使用标准化双剂量丝裂霉素。
这项关于结直肠癌患者HIPEC标准化给药的建议是加强该领域研究的重要第一步。后续需要开展旨在使七个关键要素中的每一个要素的疗效最大化的研究。
