安全施行细胞减灭术和腹腔内热灌注化疗治疗 HIV 感染患者。
Safe performance of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with HIV infection.
机构信息
Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida, USA.
Cancer Epidemiology Program, Moffitt Cancer Center, Tampa, Florida, USA.
出版信息
Cancer Rep (Hoboken). 2022 Oct;5(10):e1667. doi: 10.1002/cnr2.1667. Epub 2022 Jul 22.
BACKGROUND
Patients with HIV (PHIV) are living longer with the adoption of anti-retroviral therapy. As such, more patients are presenting with advanced cancer diagnoses, including peritoneal surface malignancies. The objective of this study was to assess the safety of CRS/HIPEC in this cohort of patients.
CASE
Five PHIV were identified, four of whom underwent CRS/HIPEC. Primary sites of disease were low-grade appendiceal mucinous tumors in three patients and peritoneal mesothelioma in the other. Operative time ranged from 7 to 14 h. One patient developed a Clavien grade II complication postoperatively. There was no instance of neutropenia identified. One patient died of disease 19 months after surgery; the remaining three patients are alive 11, 21, and 33 months postoperatively.
CONCLUSION
This study demonstrates that CRS/HIPEC can be performed in PHIV without prohibitive complications and operative recovery approximates that of non-HIV patients. Though more study is needed, HIV should not preclude a patient from being offered CRS/HIPEC.
背景
随着抗逆转录病毒疗法的采用，HIV 感染者（PHIV）的寿命越来越长。因此，更多的患者被诊断出患有晚期癌症，包括腹膜表面恶性肿瘤。本研究的目的是评估该患者群体中 CRS/HIPEC 的安全性。
病例
共发现 5 例 PHIV，其中 4 例接受了 CRS/HIPEC 治疗。3 例患者的主要疾病部位为低级别阑尾粘液性肿瘤，另 1 例为腹膜间皮瘤。手术时间从 7 小时到 14 小时不等。1 例患者术后出现 Clavien 二级并发症。未发现中性粒细胞减少症。1 例患者在手术后 19 个月死于疾病；其余 3 例患者在手术后 11、21 和 33 个月时仍然存活。
结论
本研究表明，CRS/HIPEC 可在 PHIV 患者中进行，而不会出现严重并发症，且手术恢复情况与非 HIV 患者相似。尽管需要进一步研究，但 HIV 不应阻止患者接受 CRS/HIPEC 治疗。
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