Fujimoto S, Shrestha R D, Kokubun M, Ohta M, Kobayashi K, Kiuchi S, Okui K
First Department of Surgery, School of Medicine, Chiba University, Japan.
Nihon Geka Gakkai Zasshi. 1988 Sep;89(9):1524-7.
Fourteen patients with far-advanced gastric cancer were treated surgically followed by intraperitoneal hyperthermic perfusion (IPHP) with mitomycin C (MMC) and misonidazole (MIS), a thermosensitizing drug. Immediately after extensive resection of the abdominal tumors, a 2-hour IPHP was performed at the inflow temperature 47.4 +/- 0.5 degrees C and at the outflow temperature 45.3 +/- 0.5 degrees C, using equipment designed for treatment of cancerous peritoneal seeding, as a closed circuit, and under hypothermic general anesthesia at 31.2 +/- 0.5 degrees C. In 6 of the 14 patients, cancerous ascites was absent after IPHP. Repeated cytologic examination of the lavage from pelvic cul-de-sac were negative, in all cases. The postoperative courses were uneventful except for 2 patients, in whom slight leakage occurred. All patients were discharged, and 4 in the 14 patients died of recurrence in the liver, abdominal and/or pleural cavities 8.8 +/- 2.1 months after IPHP. The remaining 10 are in good health 12.1 +/- 3.1 months after IPHP. Transient hepatic dysfunction and hypoproteinemia occurred after hyperthermia in all cases. This extensive surgery combined with IPHP using MMC and MIS was well tolerated and is a safe anti-tumor treatment for gastric cancer with peritoneal dissemination. Neurotoxicity due to MIS was nil.
14例晚期胃癌患者接受了手术治疗，随后进行腹腔内热灌注（IPHP），灌注丝裂霉素C（MMC）和热敏药物米索硝唑（MIS）。在广泛切除腹部肿瘤后，立即使用专为治疗癌性腹膜种植设计的设备，在31.2±0.5℃的低温全身麻醉下，以闭合回路形式进行2小时的IPHP，入流温度为47.4±0.5℃，出流温度为45.3±0.5℃。14例患者中有6例在IPHP后无癌性腹水。所有病例盆腔陷凹灌洗的反复细胞学检查均为阴性。除2例患者出现轻微渗漏外，术后病程平稳。所有患者均已出院，14例患者中有4例在IPHP后8.8±2.1个月死于肝、腹和/或胸腔复发。其余10例在IPHP后12.1±3.1个月身体健康。所有病例在热疗后均出现短暂性肝功能障碍和低蛋白血症。这种广泛的手术联合使用MMC和MIS的IPHP耐受性良好，是一种治疗伴有腹膜播散的胃癌的安全抗肿瘤治疗方法。MIS引起的神经毒性为零。
