Gao Tian, Huang Xiao-Xin, Wang Wu-Yun, Wu Miao-Fang, Lin Zhong-Qiu, Li Jing
Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China.
Department of Gynecology, Hangzhou Women's Hospital, Hangzhou 310008, People's Republic of China.
Cancer Manag Res. 2019 Jul 24;11:6931-6940. doi: 10.2147/CMAR.S213882. eCollection 2019.
For patients with advanced ovarian cancer, neoadjuvant chemotherapy (NACT) can significantly increase the rate of optimal cytoreduction. However, this does not translate into a survival benefit. The aim of this study was to investigate the feasibility and effect of neoadjuvant laparoscopic hyperthermic intraperitoneal chemotherapy (NLHIPEC).
Between March 2016 and February 2018, 14 patients with advanced ovarian cancer who were not candidates for optimal cytoreduction via primary debulking surgery (PDS) received NLHIPEC. Their clinical data were retrospectively analyzed.
No patients experienced intraoperative complications during NLHIPEC. Grade 3 adverse events (AEs) were noted in two (14.3%) patients, and all patients received planned NACT without dose delay or dose reduction. Following NACT, CA125 levels <35 U/mL and <20 U/mL were observed in six (42.9%) patients and five (35.7%) patients, respectively. All patients underwent interval debulking surgery (IDS) after the last NACT cycle. After IDS, R0 resection was achieved in 10 (71.4%) patients without intraoperative injury, and one (7.1%) patient developed a grade 3 AE. During a median follow-up time of 16 months, no patients died of disease, and the median progression-free survival (PFS) was not achieved. Progression was noted in six (42.9%) patients (range, 9-21 months).
NLHIPEC appears to be a feasible option for ovarian cancer patients who have a low likelihood of achieving optimal cytoreduction during PDS.
对于晚期卵巢癌患者，新辅助化疗（NACT）可显著提高最佳细胞减灭率。然而，这并未转化为生存获益。本研究的目的是探讨新辅助腹腔镜热灌注化疗（NLHIPEC）的可行性和效果。
2016年3月至2018年2月，14例无法通过初次肿瘤细胞减灭术（PDS）实现最佳细胞减灭的晚期卵巢癌患者接受了NLHIPEC。对其临床资料进行回顾性分析。
NLHIPEC期间无患者发生术中并发症。2例（14.3%）患者出现3级不良事件（AE），所有患者均接受了计划的NACT，未出现剂量延迟或剂量减少。NACT后，分别有6例（42.9%）患者和5例（35.7%）患者的CA125水平<35 U/mL和<20 U/mL。所有患者在最后一个NACT周期后接受了中间肿瘤细胞减灭术（IDS）。IDS后，10例（71.4%）患者实现了R0切除，无术中损伤，1例（7.1%）患者出现3级AE。在中位随访时间16个月期间，无患者死于疾病，未达到中位无进展生存期（PFS）。6例（42.9%）患者出现疾病进展（范围为9 - 21个月）。
对于在PDS期间实现最佳细胞减灭可能性较低的卵巢癌患者，NLHIPEC似乎是一种可行的选择。
