Boerner Thomas, Zivanovic Oliver, Chi Dennis S
Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
J Gastrointest Oncol. 2021 Apr;12(Suppl 1):S137-S143. doi: 10.21037/jgo-20-274.
Due to numerous factors, such as no specific symptoms and ineffective screening to identify premalignant or early-stage disease, most patients with ovarian cancer present with advanced-stage disease and overt peritoneal metastases. Currently, the most effective treatment for these patients is complete cytoreductive surgery with systemic platinum/taxane-based chemotherapy. Over the past few decades, many researchers have evaluated the use of postoperative normothermic intraperitoneal (NIPEC) and intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) delivery as additional treatment modalities. Here, we will review the current status and future directions for these treatment strategies in the management of ovarian cancer. Most of the studies in this area of research have been retrospective in nature, limited by heterogeneous patient populations and large variance in chemotherapeutic regimens used, leading to mixed results and difficulties in evaluating the clinical impact of the data. More mature data from prospective trials are lacking, and IP therapy for advanced ovarian cancer should still be considered an investigational approach and evaluated only in clinical trials; the exception is for patients with stage III disease who undergo interval debulking surgery after neoadjuvant chemotherapy, for whom HIPEC can be considered in selected patients as part of first-line therapy.
由于多种因素，如无特定症状以及用于识别癌前病变或早期疾病的筛查无效，大多数卵巢癌患者就诊时已处于晚期且伴有明显的腹膜转移。目前，对于这些患者最有效的治疗方法是进行彻底的细胞减灭术并辅以基于铂类/紫杉烷的全身化疗。在过去几十年中，许多研究人员评估了术后常温腹腔内化疗（NIPEC）和术中热腹腔内化疗（HIPEC）作为额外治疗方式的应用。在此，我们将综述这些治疗策略在卵巢癌管理中的现状及未来方向。该研究领域的大多数研究本质上都是回顾性的，受患者群体异质性以及所用化疗方案差异较大的限制，导致结果不一且难以评估数据的临床影响。缺乏来自前瞻性试验的更成熟数据，晚期卵巢癌的腹腔内治疗仍应被视为一种试验性方法，仅在临床试验中进行评估；例外情况是新辅助化疗后接受间隔性肿瘤细胞减灭术的III期疾病患者，对于这些患者，可在部分选定患者中将HIPEC视为一线治疗的一部分。
