Murono Koji, Kawai Kazushige, Hata Keisuke, Emoto Shigenobu, Kaneko Manabu, Sasaki Kazuhito, Nishikawa Takeshi, Otani Kensuke, Tanaka Toshiaki, Nozawa Hiroaki
Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, Tokyo, Japan
Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, the University of Tokyo, Tokyo, Japan.
Anticancer Res. 2018 Jan;38(1):15-22. doi: 10.21873/anticanres.12186.
Although systemic chemotherapy has been improved, peritoneal carcinomatosis remains a factor of poor prognosis in patients with colorectal cancer. In order to achieve a higher drug concentration in the peritoneal cavity, intraperitoneal chemotherapy has been performed. However, the optimal regimen for intraperitoneal chemotherapy has not been determined. In this review of intraperitoneal chemotherapy for colorectal cancer, we summarize regimens of hyperthermic intraperitoneal chemotherapy (HIPEC) and other intraperitoneal chemotherapy modalities, such as early postoperative intraperitoneal chemotherapy (EPIC) and sequential postoperative intraperitoneal chemotherapy (SPIC). Mitomycin C and oxaliplatin are the most common chemotherapeutic agents used for HIPEC. Some combination therapies such as those involving bevacizumab, HO, and amifostine have potential to increase HIPEC efficacy. 5-Fluorouracil is used mainly for EPIC and SPIC. Some new agents such as paclitaxel, melphalan, and various nanoparticles have been developed. These novel chemotherapeutic agents may achieve clinical implementation in the future.
尽管全身化疗已有所改进,但腹膜癌病仍是结直肠癌患者预后不良的一个因素。为了在腹腔内达到更高的药物浓度,已开展了腹腔内化疗。然而,腹腔内化疗的最佳方案尚未确定。在这篇关于结直肠癌腹腔内化疗的综述中,我们总结了热灌注腹腔内化疗(HIPEC)方案以及其他腹腔内化疗方式,如术后早期腹腔内化疗(EPIC)和序贯术后腹腔内化疗(SPIC)。丝裂霉素C和奥沙利铂是用于HIPEC最常用的化疗药物。一些联合治疗,如涉及贝伐单抗、HO和氨磷汀的联合治疗,有可能提高HIPEC疗效。5-氟尿嘧啶主要用于EPIC和SPIC。一些新型药物如紫杉醇、美法仑和各种纳米颗粒已被研发出来。这些新型化疗药物未来可能会实现临床应用。