Ye J W, Hu H B, Luo R, Wang H M, Huang R K, Chu L L, Wang H
Department of General Surgery (Colorectal Surgery), the Sixth Affiliated Hospital, Sun Yat-sen University;Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University;Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University,Guangdong Province Biomedical Material Conversion and Evaluation Engineering Technology Center, Guangzhou 510655, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2024 Jun 25;27(6):646-652. doi: 10.3760/cma.j.cn441530-20230522-00177.
Peritoneal metastasis is one of the common site of colorectal cancer metastasis and associated with a poor prognosis. The core strategy for colorectal cancer peritoneal metastasis primarily revolves around a comprehensive treatment approach with cytoreductive surgery and systemic chemotherapy as the mainstay, supplemented by intraperitoneal chemotherapy. As an important supplement to treatment, intraperitoneal chemotherapy has broad application prospects. The main modalities are hyperthermic intraperitoneal chemotherapy (HIPEC), neoadjuvant intraperitoneal and systemic chemotherapy (NIPS), early postoperative intraperitoneal chemotherapy (EPIC), sequential postoperative intraperitoneal chemotherapy (SPIC), normothermic intraperitoneal chemotherapy (NIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC). To promote the standardized application of intraperitoneal chemotherapy, further research on the mechanisms underlying peritoneal metastasis of colorectal cancer, selection of effective intraperitoneal chemotherapy agents, determination of optimal timing and administration protocols, exploration of the feasibility of sequential intraperitoneal chemotherapy and conduction of valuable basic and clinical research are currently needed. This paper will review the development and origins of intraperitoneal chemotherapy, treatment modalities, as well as the current application status and prospects of various treatment approaches in the context of peritoneal metastasis of colorectal cancer.
腹膜转移是结直肠癌转移的常见部位之一,且与预后不良相关。结直肠癌腹膜转移的核心策略主要围绕以细胞减灭术和全身化疗为主、腹腔内化疗为辅的综合治疗方法展开。腹腔内化疗作为治疗的重要补充,具有广阔的应用前景。主要方式有热灌注腹腔内化疗(HIPEC)、新辅助腹腔内和全身化疗(NIPS)、术后早期腹腔内化疗(EPIC)、序贯术后腹腔内化疗(SPIC)、常温腹腔内化疗(NIPEC)和加压腹腔内气溶胶化疗(PIPAC)。为促进腹腔内化疗的规范应用,目前需要进一步研究结直肠癌腹膜转移的机制、选择有效的腹腔内化疗药物、确定最佳时机和给药方案、探索序贯腹腔内化疗的可行性以及开展有价值的基础和临床研究。本文将综述腹腔内化疗的发展历程、起源、治疗方式以及在结直肠癌腹膜转移背景下各种治疗方法的当前应用现状和前景。