a Department of Peritoneal Cancer Surgery , Beijing Shijitan Hospital, Capital Medical University , Beijing , China.
b Department of Oncology , Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors and Hubei Cancer Clinical Study Center , Wuhan , China.
Int J Hyperthermia. 2017 Aug;33(5):562-570. doi: 10.1080/02656736.2017.1283065.
There is no standard treatment for peritoneal metastases (PM) from gastric cancer (GC). The aim of this review is to evaluate the clinical trials on cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) for GC PM.
The published clinical trials on CRS + HIPEC for GC PM are critically evaluated, and survival and safety are the primary endpoints. In addition, the registered ongoing clinical trials are summarised.
The natural course of GC PM is <5 months. CRS + HIPEC could improve the overall survival (OS). In prospective studies, the median OS was 11.0 months in the CRS + HIPEC group vs. 5.4 months in the CRS alone group. In case-control studies, the median OS was 13.3 months in the CRS + HIPEC group vs. 7.9 months in the CRS alone group. In cohort studies, the median OS after CRS + HIPEC was 13.3. The median 1-, 2- and 5-year survival rates after CRS + HIPEC were 50.0%, 35.8% and 13.0%, respectively. There is no statistically significant increase in serious adverse events that are directly attributed to CRS + HIPEC.
The combination of CRS and HIPEC is a promising integrated treatment strategy for GC PM that has encouraging initial results, calling for urgent further evaluation of this strategy in randomised control trials (RCTs).
胃癌（GC）腹膜转移（PM）目前尚无标准治疗方法。本研究旨在评估细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）治疗 GC PM 的临床试验。
对 CRS+HIPEC 治疗 GC PM 的已发表临床试验进行了严格评估，以生存和安全性为主要终点。此外，还总结了正在注册的临床试验。
GC PM 的自然病程<5 个月。CRS+HIPEC 可提高总生存率（OS）。在前瞻性研究中，CRS+HIPEC 组的中位 OS 为 11.0 个月，而 CRS 组为 5.4 个月。在病例对照研究中，CRS+HIPEC 组的中位 OS 为 13.3 个月，CRS 组为 7.9 个月。在队列研究中，CRS+HIPEC 后的中位 OS 为 13.3 个月。CRS+HIPEC 后 1、2 和 5 年的中位生存率分别为 50.0%、35.8%和 13.0%。CRS+HIPEC 直接导致的严重不良事件并无统计学显著增加。
CRS 联合 HIPEC 是一种很有前途的 GC PM 综合治疗策略，具有令人鼓舞的初步结果，呼吁在随机对照试验（RCT）中进一步评估该策略。
