Liu Lili, Zhang Ning, Min Jie, Su Haichuan, Wang Hongmei, Chen Dongxu, Sun Li, Zhang Hongwei, Li Wei, Zhang Helong
Department of Oncology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
Department of Gastroenterological Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Oncotarget. 2016 Apr 19;7(16):21570-8. doi: 10.18632/oncotarget.7622.
The current study was designed to analyze safety of the bedside hyperthermic intra-pleural or intra-peritoneal chemotherapy (HIPEC) from September 2007 to July 2015. Total of 5,759 times of bedside HIPEC in 985 cases of malignant pleural or peritoneal carcinomatosis were analyzed. Of them, 1,510 times was given to 315 cases of malignant pleural effusion, while 4,249 times was performed in 402 patients with malignant ascites and 268 patients without ascites (total 670 patients for peritoneal carcinomatosis). In average, patients with pleural effusion was given 5 times bedside HIPEC and stayed in the hospital for 6.7 days; while patients with peritoneal carcinomatosis was given 6 times of HIPEC and stayed in the hospital for 6.5 days. Overall HIPEC-associated mortality was zero. Overall HIPEC-associated incidence of side effect in the intra-pleural HIPEC was 2.0%. Specifically, 0.6% was pneumothorax, 0.3% was cytotoxic agent-induced pleural inflammation, 0.5% was pain at puncture location, and 0.3% was failure of HIPEC procedure. Overall HIPEC-associated incidence of side effect in the intra-peritoneal HIPEC was 2.4%, i.e., failure of HIPEC procedure in 1.3%, pain at puncture location was 0.5%, cytotoxic agent-induced peritoneal inflammation was 0.1%, intestinal obstruction was 0.1% and intestinal perforation was 0.07%. These findings indicated that bedside HIPEC applied in the current study is safe to be performed by a Physician or Oncologist under local anesthesia at a patient's bedside. The procedure is easy to perform and well-tolerated by the patients with late stage cancer or post-surgery recurrent cancer.
本研究旨在分析2007年9月至2015年7月期间床边胸腔或腹腔热灌注化疗（HIPEC）的安全性。对985例恶性胸腔或腹腔癌转移患者的5759次床边HIPEC进行了分析。其中，315例恶性胸腔积液患者接受了1510次治疗，402例恶性腹水患者和268例无腹水患者（共670例腹腔癌转移患者）接受了4249次治疗。胸腔积液患者平均接受5次床边HIPEC治疗，住院6.7天；腹腔癌转移患者平均接受6次HIPEC治疗，住院6.5天。总体HIPEC相关死亡率为零。胸腔内HIPEC的总体副作用发生率为2.0%。具体而言，气胸发生率为0.6%，细胞毒性药物引起的胸膜炎发生率为0.3%，穿刺部位疼痛发生率为0.5%，HIPEC手术失败率为0.3%。腹腔内HIPEC的总体副作用发生率为2.4%，即HIPEC手术失败率为1.3%，穿刺部位疼痛发生率为0.5%，细胞毒性药物引起的腹膜炎发生率为0.1%，肠梗阻发生率为0.1%，肠穿孔发生率为0.07%。这些结果表明，本研究中应用的床边HIPEC由医生或肿瘤学家在患者床边局部麻醉下进行是安全的。该手术操作简便，晚期癌症或术后复发癌患者耐受性良好。
