Wilson Jenna, Ayyappan Aishwarya, Crocker Andrew B, Kwon Steve
St. Elizabeth Medical Center, Brighton, MA.
Boston University; Roger Williams Medical Center, Providence, RI.
R I Med J (2013). 2025 Jul 1;108(7):14-19.
Peritoneal carcinomatosis presents significant therapeutic challenges due to the unique characteristics of peritoneal metastases, such as their widespread nature, variability in size, and limited blood supply. Intraperitoneal chemotherapy (IPC) was first introduced in 1955 as a targeted treatment modality to address these challenges. By delivering cytotoxic agents directly into the peritoneal cavity, IPC enhances drug concentration at tumor sites while minimizing systemic toxicity. Two primary methods of IPC are Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Early Postoperative Intraperitoneal Chemotherapy (EPIC), each with distinct protocols and advantages. HIPEC is administered during cytoreductive surgery under hyperthermic conditions, while EPIC is applied post-surgery over an extended period. Patient selection is critical, and the technique is most effective when tumor burden is manageable post-cytoreduction. This review explores the molecular properties of IPC agents, their clinical applications across various cancers, adverse effects, and long-term outcomes, highlighting IPC's potential as a life-saving treatment for patients with peritoneal metastases.
由于腹膜转移瘤具有广泛分布、大小不一和血供有限等独特特征,腹膜癌病带来了重大的治疗挑战。腹腔内化疗(IPC)于1955年首次被引入,作为一种针对性的治疗方式来应对这些挑战。通过将细胞毒性药物直接输送到腹腔,IPC提高了肿瘤部位的药物浓度,同时将全身毒性降至最低。IPC的两种主要方法是热灌注腹腔内化疗(HIPEC)和术后早期腹腔内化疗(EPIC),每种方法都有不同的方案和优势。HIPEC在减瘤手术期间于高温条件下给药,而EPIC在手术后较长时间内应用。患者选择至关重要,当肿瘤负荷在减瘤后可控时,该技术最为有效。本综述探讨了IPC药物的分子特性、它们在各种癌症中的临床应用、不良反应和长期结果,突出了IPC作为腹膜转移患者挽救生命治疗方法的潜力。