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白蛋白结合型紫杉醇在胃癌术中及术后热灌注腹腔化疗中的短期安全性评估

Short-Term Safety Evaluation of Albumin-Bound Paclitaxel in Intraoperative and Postoperative Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer.

作者信息

Zhou Jingxiang, Cai Xiaopeng, Lu Zhao, Xiong Bin, Peng Chunwei

机构信息

Second Clinical College, Wuhan University, Wuhan , Hubei Province, 430070, China.

Department of Gastrointestinal Surgery, the Center for Minimally Invasive Surgery of Gastrointestinal Cancer, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan Peritoneal Cancer Clinical Medical Center, Zhongnan Hospital of Wuhan University, No. 169 Donghu Road, Wuchang District, Hubei Province, 430070, China.

出版信息

J Gastrointest Cancer. 2024 Jun;55(2):877-887. doi: 10.1007/s12029-024-01031-9. Epub 2024 Feb 17.

Abstract

PURPOSE

To evaluate the short-term safety of albumin-bound paclitaxel in hyperthermic intraperitoneal chemotherapy (HIPEC) during and after gastric cancer (GC) surgery.

METHODS

A retrospective analysis of clinical data was conducted for GC surgery patients at Zhongnan Hospital of Wuhan University, from January 2020 to September 2022. The study group (n = 120) received HIPEC and the control group (n = 268) did not receive albumin-bound paclitaxel. Short-term safety indicators including intraoperative complications, hematological toxicity, liver and kidney function, and gastrointestinal function recovery were compared between the two groups.

RESULTS

There were no statistically significant differences between the two groups regarding intraoperative complications, hematological toxicity, liver and kidney function, and gastrointestinal function recovery time (P > 0.05 for all). In the study group, patients were further divided into subgroups based on dose and timing. Subgroup analysis revealed no significant differences among the different dose subgroups. However, when focusing on timing subgroups, the postoperative subgroup exhibited significantly higher white blood cell counts and bilirubin levels compared to the intraoperative subgroup, while the intraoperative subgroup had significantly higher bilirubin levels compared to both postoperative and intraoperative plus postoperative subgroups.

CONCLUSION

Albumin-bound paclitaxel demonstrates good safety and tolerability in HIPEC during and after GC surgery, without increasing the risk of intraoperative complications.

摘要

目的

评估白蛋白结合型紫杉醇在胃癌(GC)手术期间及术后的热腹腔内化疗(HIPEC)中的短期安全性。

方法

对武汉大学中南医院2020年1月至2022年9月期间接受GC手术的患者的临床资料进行回顾性分析。研究组(n = 120)接受HIPEC,对照组(n = 268)未接受白蛋白结合型紫杉醇。比较两组的短期安全指标,包括术中并发症、血液学毒性、肝肾功能和胃肠功能恢复情况。

结果

两组在术中并发症、血液学毒性、肝肾功能和胃肠功能恢复时间方面无统计学显著差异(所有P > 0.05)。在研究组中,患者根据剂量和给药时间进一步分为亚组。亚组分析显示不同剂量亚组之间无显著差异。然而,在关注给药时间亚组时,术后亚组的白细胞计数和胆红素水平显著高于术中亚组,而术中亚组的胆红素水平显著高于术后亚组和术中加术后亚组。

结论

白蛋白结合型紫杉醇在GC手术期间及术后的HIPEC中显示出良好的安全性和耐受性,且不增加术中并发症的风险。

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