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腹膜转移的腹腔内化疗:技术创新、临床前和临床进展以及未来展望。

Intraperitoneal Chemotherapy for Peritoneal Metastases: Technical Innovations, Preclinical and Clinical Advances and Future Perspectives.

作者信息

Christou Niki, Auger Clément, Battu Serge, Lalloué Fabrice, Jauberteau-Marchan Marie-Odile, Hervieu Céline, Verdier Mireille, Mathonnet Muriel

机构信息

Service de Chirurgie Digestive, Endocrinienne et Générale, CHU de Limoges, Avenue Martin Luther King, 87042 Limoges CEDEX, France.

Department of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.

出版信息

Biology (Basel). 2021 Mar 15;10(3):225. doi: 10.3390/biology10030225.

Abstract

(1) Background: Tumors of the peritoneal serosa are called peritoneal carcinosis. Their origin may be primary by primitive involvement of the peritoneum (peritoneal pseudomyxoma, peritoneal mesothelioma, etc.). This damage to the peritoneum can also be a consequence of the dissipation of cancers-in particular, digestive (stomach, pancreas, colorectal, appendix) and gynecological (ovaries) ones in the form of metastases. The aim of the treatment is a maximal reduction of the macroscopic disease called "cytoreduction" in combination with hyperthermic intra-abdominal chemotherapy to treat residual microscopic lesions. (2) Methods: In this narrative review, we fundamentally synthetize the evolution of this process over time and its impact on clinical applications. (3) Results: Over the last past decade, different evolutions concerning both delivery modes and conditions concerning hyperthermic intra-abdominal chemotherapy have been realized. (4) Conclusion: The final objective of these evolutions is the improvement of the global and recurrence-free survival of primary and secondary malignant peritoneal pathologies. However, more large randomized controlled trials are needed to demonstrate the efficacy of such treatments with the help of molecular biology and genetics.

摘要

(1) 背景:腹膜浆膜肿瘤称为腹膜癌。其起源可能是原发性的,由腹膜的原始受累引起(腹膜假黏液瘤、腹膜间皮瘤等)。腹膜的这种损害也可能是癌症播散的结果,尤其是消化系统(胃、胰腺、结肠直肠、阑尾)和妇科(卵巢)癌症以转移形式导致的。治疗目的是最大程度减少称为“肿瘤细胞减灭术”的宏观病变,并结合腹腔内热化疗来治疗残留的微观病变。(2) 方法:在本叙述性综述中,我们从根本上综合了这一过程随时间的演变及其对临床应用的影响。(3) 结果:在过去十年中,腹腔内热化疗的给药方式和条件都有了不同的演变。(4) 结论:这些演变的最终目标是提高原发性和继发性恶性腹膜病变的总体生存率和无复发生存率。然而,需要更多大型随机对照试验,借助分子生物学和遗传学来证明此类治疗的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c63/8001167/9dc19ff21e7f/biology-10-00225-g001.jpg

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