Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands.
Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro, Viale Europa, 88100 Catanzaro, CZ, Italy.
Crit Rev Oncol Hematol. 2019 Oct;142:119-129. doi: 10.1016/j.critrevonc.2019.06.014. Epub 2019 Jul 9.
The role of hyperthermic intraperitoneal chemotherapy (HIPEC) with oxaliplatin in addition to cytoreductive surgery (CRS) has recently been questioned in peritoneal metastases of colorectal cancer. Whether this applies to all published CRS/HIPEC regimens is unclear.
A systematic literature search identified 46 studies on CRS/HIPEC using either oxaliplatin of mitomycin C with at least one oncological outcome parameter RESULTS: Oxaliplatin and mitomycin C studies were comparable regarding extent of disease, but differed substantially regarding synchronous versus metachronous presentation, application of neo-adjuvant systemic chemotherapy, duration of HIPEC, and completeness of cytoreduction for at least one of the oncological endpoints. Severe postoperative complication rate seemed significantly higher after oxaliplatin-based CRS/HIPEC.
Published cohorts on oxaliplatin-based CRS/HIPEC differed essentially from MMC-based procedures, especially considering the application of oxaliplatin-containing neo-adjuvant systemic therapy and shorter exposure time to intraperitoneal chemotherapy in oxaliplatin studies. No meaningful comparison could be made regarding DFS and OS.
在结直肠肿瘤腹膜转移中，奥沙利铂联合细胞减灭术（CRS）的腹腔内热化疗（HIPEC）的作用最近受到质疑。目前尚不清楚这是否适用于所有已发表的 CRS/HIPEC 方案。
系统文献检索确定了 46 项关于 CRS/HIPEC 的研究，这些研究均使用奥沙利铂或丝裂霉素 C，并至少有一个肿瘤学结局参数。
奥沙利铂和丝裂霉素 C 研究在疾病程度方面具有可比性，但在同步或异时表现、新辅助全身化疗的应用、HIPEC 持续时间以及至少一个肿瘤学终点的细胞减灭术完全性方面存在显著差异。奥沙利铂为基础的 CRS/HIPEC 术后严重并发症发生率明显较高。
基于奥沙利铂的 CRS/HIPEC 的已发表队列与基于丝裂霉素 C 的方案在本质上存在显著差异，特别是考虑到奥沙利铂联合新辅助全身治疗的应用以及奥沙利铂研究中腹腔内化疗的暴露时间更短。在 DFS 和 OS 方面无法进行有意义的比较。
