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细胞减灭术联合洛铂与多西他赛腹腔热灌注化疗治疗胃癌同步性腹膜转移癌:来自中国一家中心的结果

Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy with lobaplatin and docetaxel to treat synchronous peritoneal carcinomatosis from gastric cancer: Results from a Chinese center.

作者信息

Wu H-T, Peng K-W, Ji Z-H, Sun J-H, Zhang Q, Yang X-J, Huang C-Q, Li Y

机构信息

Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital Affiliated to the Capital Medical University, Beijing, 100038, China; Department of Oncology, Zhongnan Hospital Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors and Hubei Cancer Clinical Study Center, Wuhan, 430071, China.

Department of Oncology, Zhongnan Hospital Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors and Hubei Cancer Clinical Study Center, Wuhan, 430071, China.

出版信息

Eur J Surg Oncol. 2016 Jul;42(7):1024-34. doi: 10.1016/j.ejso.2016.04.053. Epub 2016 May 3.

Abstract

BACKGROUND

This work was to evaluate the efficacy and safety of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) with lobaplatin and docetaxel to treat peritoneal carcinomatosis (PC) from gastric cancer (GC).

METHODS

A total of 50 consecutive GC PC patients treated by 52 CRS+HIPEC procedures with lobaplatin 50 mg/m(2) and docetaxel 60 mg/m(2) in 6000 mL of normal saline at (43 ± 0.5) °C for 60 min. The primary endpoint was overall survival (OS), and the secondary endpoints were perioperative safety profiles.

RESULTS

At the median follow-up of 22.5 (range, 5.1-50.7) months, the median OS was 14.3 (95% CI 7.6-21.0) months, and the 1-, 2-, and 3-year survival rates were 58%, 40%, and 32%, respectively. Mortality and serious adverse event (grade 3-5) morbidity rates in postoperative 30 days were 0.0% and 23.1%, respectively. Univariate analysis identified 4 parameters with significant effects on OS: completeness of cytoreduction (CC) 0-1, normal (N) the preoperative tumor markers level (TM), adjuvant chemotherapy ≥6 cycles, and peritoneal cancer index ≤20. However, multivariate analysis identified CC0-1, perioperative TM (N), adjuvant chemotherapy ≥6 cycles as the independent predictor for better survival.

CONCLUSIONS

CRS+HIPEC with lobaplatin and docetaxel to treat selected GC PC could improve OS, with acceptable perioperative safety.

摘要

背景

本研究旨在评估细胞减灭术(CRS)联合洛铂和多西他赛的热腹腔内化疗(HIPEC)治疗胃癌(GC)腹膜转移癌(PC)的疗效及安全性。

方法

共有50例连续性GC PC患者接受了52次CRS+HIPEC治疗,将50mg/m²洛铂和60mg/m²多西他赛加入6000mL生理盐水中,在(43±0.5)℃下持续灌注60分钟。主要终点为总生存期(OS),次要终点为围手术期安全性。

结果

中位随访时间为22.5(范围5.1 - 50.7)个月,中位OS为14.3(95%CI 7.6 - 21.0)个月,1年、2年和3年生存率分别为58%、40%和32%。术后30天的死亡率和严重不良事件(3 - 5级)发病率分别为0.0%和23.1%。单因素分析确定了4个对OS有显著影响的参数:细胞减灭的完全性(CC)0 - 1、术前肿瘤标志物水平(TM)正常(N)、辅助化疗≥6周期以及腹膜癌指数≤20。然而,多因素分析确定CC0 - 1、围手术期TM(N)、辅助化疗≥6周期是更好生存的独立预测因素。

结论

洛铂和多西他赛联合CRS+HIPEC治疗特定的GC PC可改善OS,围手术期安全性可接受。

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