González Gil Alida, Cerezuela Fernández-de Palencia Álvaro, Gómez Ruiz Álvaro Jesús, Gil Gómez Elena, López Hernández Francisco, Nieto Ruiz Aníbal, Martínez Jerónimo, Marhuenda Iván, Cascales Campos Pedro Antonio
Departamento de Cirugía, Unidad de Cirugía Oncológica Peritoneal, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-ARRIXACA, 30120 Murcia, Spain.
Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-ARRIXACA, 30120 Murcia, Spain.
Cancers (Basel). 2023 Jul 4;15(13):3481. doi: 10.3390/cancers15133481.
Ovarian cancer is the leading cause of death due to gynecological tumors in the female population. Despite optimal first-line treatment, including cytoreduction and platinum-based systemic chemotherapy, recurrences are frequent. The use of hyperthermic intraperitoneal chemotherapy (HIPEC) has been criticized, especially because of the lack of randomized controlled trials (RCTs) with convincing results to support the use of HIPEC in patients with ovarian cancer with peritoneal dissemination. In 2018, the clinical trial published by Van Driel et al. reported improved outcomes in favor of HIPEC treatment with cisplatin. In this study, we conducted a national survey within the Spanish group of peritoneal surgical oncology (Grupo Español de Cirugía Oncológica Peritoneal, GECOP) to explore the impact of the results of this RCT on clinical practice. A total of 33 groups completed the survey. Routine clinical practice was not changed in 28 of the 33 groups (85%) based on the results of the Van Driel trial. Despite the results of this RCT, most groups considered that more RCTs are needed and that, in the future, HIPEC may become the standard of care. In conclusion, the results from RCTs evaluating HIPEC treatment in patients with ovarian cancer has not been transferred to clinical practice.
卵巢癌是女性人群中因妇科肿瘤导致死亡的主要原因。尽管有包括肿瘤细胞减灭术和铂类全身化疗在内的最佳一线治疗方案，但复发仍很常见。热灌注化疗（HIPEC）的应用受到了批评，尤其是因为缺乏随机对照试验（RCT），没有令人信服的结果支持在有腹膜播散的卵巢癌患者中使用HIPEC。2018年，Van Driel等人发表的临床试验报告称，顺铂HIPEC治疗的结果有所改善。在本研究中，我们在西班牙腹膜外科肿瘤学组（Grupo Español de Cirugía Oncológica Peritoneal, GECOP）内进行了一项全国性调查，以探讨该RCT结果对临床实践的影响。共有33个组完成了调查。基于Van Driel试验的结果，33个组中有28个组（85%）的常规临床实践没有改变。尽管有该RCT的结果，但大多数组认为仍需要更多的RCT，并且在未来，HIPEC可能会成为标准治疗方法。总之，评估卵巢癌患者HIPEC治疗的RCT结果尚未转化为临床实践。
