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细胞减灭术(CRS)与腹腔内热灌注化疗(HIPEC)在腹膜表面恶性肿瘤多模式治疗中的现状

Current status of cytoreductive surgery (CRS) and intraperitoneal hyperthermic chemotherapy (HIPEC) in the multimodal treatment of peritoneal surface malignancies.

作者信息

Klos Dušan, Riško Juraj, Stašek Martin, Loveček Martin, Hanuliak Jan, Skalický Pavel, Lemstrová Radmila, Mohelníková Beatrice Duchoňová, Študentová Hana, Neoral Čestmír, Melichar Bohuslav

出版信息

Cas Lek Cesk. 2018 Dec 17;157(8):419-428.

Abstract

The tumors of the peritoneal surface, both primary and secondary, are associated with a very poor prognosis and rapid progression through conventional oncology treatment including systemic chemotherapy, targeted treatment, radiotherapy, surgery, and symptomatic treatment. Until recently, most of them were considered incurable. In the 1980s, the first cytoreductive surgery ("CRS") combined with intraperitoneal hyperthermic chemotherapy ("HIPEC") became the standard of treatment for selected tumor peritoneal tumor (pseudomyxoma peritonei and primary peritoneal malignant mesothelioma). In some cases of other peritoneal carcinomatosis associated with colorectal cancer, gastric cancer and ovarian cancer in the subgroup of well selected patients, this treatment can lead to a significant prolongation of overall survival and good standard of quality of life. This method is safe in specialized centers with an acceptable rate of morbidity and mortality comparable to foreign workplaces and is also available for patients in the Czech Republic. Key words surgery, oncology, cytoreduction, intraperitoneal chemotherapy, hyperthermia.

摘要

原发性和继发性腹膜表面肿瘤的预后都很差,通过包括全身化疗、靶向治疗、放疗、手术及对症治疗在内的传统肿瘤治疗方法,其病情进展迅速。直到最近,大多数此类肿瘤仍被认为无法治愈。在20世纪80年代,首例减瘤手术(“CRS”)联合腹腔内热灌注化疗(“HIPEC”)成为特定腹膜肿瘤(腹膜假黏液瘤和原发性腹膜恶性间皮瘤)的治疗标准。在精心挑选的患者亚组中,对于与结直肠癌、胃癌和卵巢癌相关的其他腹膜癌转移的某些病例,这种治疗可显著延长总生存期并提高生活质量标准。在专业中心,这种方法是安全的,其发病率和死亡率可接受,与国外机构相当,捷克共和国的患者也可采用。关键词手术、肿瘤学、减瘤、腹腔内化疗、热疗

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