Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Curr Oncol. 2023 Jan 21;30(2):1488-1501. doi: 10.3390/curroncol30020114.
The drug selection of radical surgery (RS), with hyperthermic intraperitoneal chemotherapy (HIPEC), in pT4 colorectal cancer (CRC) remains controversial.
Adverse events after HIPEC were estimated by common terminology criteria for adverse events version 5.0. The efficacy was evaluated using overall survival (OS) and recurrence-free rate (RFR). Propensity score matching (PSM) was used to reduce the influence of confounders between Mitomycin and Lobaplatin groups.
Of the 146 patients, from April 2020 to March 2021, 47 were managed with mitomycin and 99 with lobaplatin. There was no significant difference in the incidence of all adverse events between the two groups after PSM. OS and RFR were not significantly different between the two groups at 22 months ( = 0.410; = 0.310). OS and RFR of the two groups also showed no significant difference for patients with T4a or T4b stage, tumor size < or ≥ 5 cm. Among patients with colon cancer, RFR at 22 months of the two groups was significantly different (100.0% vs. 63.2%, = 0.028).
In summary, the safety of mitomycin and lobaplatin for HIPEC was not different. Compared with lobaplatin, mitomycin for HIPEC after RS could benefit patients with colon cancer in RFR.
对于 T4 期结直肠癌(CRC)患者,根治性手术(RS)联合腹腔内热灌注化疗(HIPEC)的药物选择仍存在争议。
采用不良事件通用术语标准 5.0 版评估 HIPEC 后的不良事件。采用总生存期(OS)和无复发生存率(RFR)评估疗效。采用倾向评分匹配(PSM)降低丝裂霉素和洛铂组之间混杂因素的影响。
在 2020 年 4 月至 2021 年 3 月期间,146 例患者中,47 例采用丝裂霉素,99 例采用洛铂。PSM 后两组所有不良事件的发生率无显著差异。22 个月时,两组 OS 和 RFR 无显著差异( = 0.410; = 0.310)。两组 T4a 或 T4b 期、肿瘤大小<5cm 或≥5cm 的患者 OS 和 RFR 也无显著差异。在结肠癌患者中,两组 22 个月时的 RFR 有显著差异(100.0%比 63.2%, = 0.028)。
总之,丝裂霉素和洛铂用于 HIPEC 的安全性无差异。与洛铂相比,RS 后 HIPEC 中使用丝裂霉素可能使结肠癌患者的 RFR 获益。