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洛铂联合多西他赛行肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜癌的临床观察

武海涛, 杨肖军, 孙建华, 黄超群, 姬忠贺, 龚俊, 李雁

武海涛, 杨肖军, 孙建华, 黄超群, 姬忠贺, 龚俊, 李雁. 洛铂联合多西他赛行肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜癌的临床观察[J]. 肿瘤防治研究, 2016, 43(2): 150-157. DOI: 10.3971/j.issn.1000-8578.2016.02.012
引用本文: 武海涛, 杨肖军, 孙建华, 黄超群, 姬忠贺, 龚俊, 李雁. 洛铂联合多西他赛行肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜癌的临床观察[J]. 肿瘤防治研究, 2016, 43(2): 150-157. DOI: 10.3971/j.issn.1000-8578.2016.02.012
WU Haitao, YANG Xiaojun, SUN Jianhua, HUANG Chaoqun, JI Zhonghe, GONG Jun, LI Yan. Clinical Observation of Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy with Lobaplatin and Docetaxel on Peritoneal Carcinoma[J]. Cancer Research on Prevention and Treatment, 2016, 43(2): 150-157. DOI: 10.3971/j.issn.1000-8578.2016.02.012
Citation: WU Haitao, YANG Xiaojun, SUN Jianhua, HUANG Chaoqun, JI Zhonghe, GONG Jun, LI Yan. Clinical Observation of Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy with Lobaplatin and Docetaxel on Peritoneal Carcinoma[J]. Cancer Research on Prevention and Treatment, 2016, 43(2): 150-157. DOI: 10.3971/j.issn.1000-8578.2016.02.012

洛铂联合多西他赛行肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜癌的临床观察

基金项目: 2013年湖北省医学领军人才培养工程项目( 鄂卫生计生发[ 2 0 1 3 ] 4 号) , 教育部博士点基金(20120141110042)
详细信息
    作者简介:

    武海涛(1987-),男,硕士在读,主要从事腹膜癌基础和临床研究

    杨肖军(1980-),男,主治医师,主要从事腹膜癌基础和临床研究(*:并列第一作者)

    通讯作者:

    李雁,E-mail: liyansd2@163.com

  • 中图分类号: R730.5

Clinical Observation of Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy with Lobaplatin and Docetaxel on Peritoneal Carcinoma

  • 摘要: 目的 分析洛铂联合多西他赛行肿瘤细胞减灭术(cytoreductive surgery, CRS)加腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy, HIPEC)治疗腹膜癌(peritoneal carcinoma, PC)的围手术期安全性及疗效。 方法 PC患者行CRS+HIPEC治疗,药物为洛铂50 mg/m2、多西他赛60 mg/m2,加入12 000 ml 0.9%氯化钠溶液加热至(43±0.5)℃持续灌注60 min。记录术后6天体温和心率变化、围手术期不良事件、血常规及血生化指标、术后患者恢复情况及生存结果。结果 90例PC患者行95次CRS+HIPEC,手术时间180~450 min (中位数485 min);术后6天最高体温、心率分别为36.4℃~38.6℃(中位数37.5℃)、76~124 bpm(中位数100 bpm),严重不良事件16例,包括围手术期死亡2例。中位生存期20.8月(95%CI: 13.1~25.8月),1、3、5年生存率分别为75.6%、45.6%、43.3%。 结论 洛铂联合多西他赛进行CRS+HIPEC治疗PC安全性可接受,有助于延长患者生存期。

     

    Abstract: Objective To investigate the perioperative safety and efficacy of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy(HIPEC) with lobaplatin (LBP) and docetaxel (TXT) on peritoneal carcinoma(PC) patients. Methods PC patients were treated with CRS+HIPEC using LBP 50 mg/m2 and TXT 60 mg/m2 in 12000 ml of normal saline at (43±0.5)℃ for 60 min. Body temperature and heart rate were recorded for 6 d after CRS plus HIPEC. Perioperative adverse events, hematological, hepatic, renal and electrolytes parameters, patients recovery and survival outcomes were analyzed. Results 90 PC patients were treated with 95 CRS plus HIPEC procedures, with the median duration of 485 min (180-450 min). The highest temperature and heart rate during six postoperative days were 36.4-38.6℃(median 37.5℃) and 76-124 bpm(median 100 bpm), respectively. Severe adverse events occurred in 16 patients, including two patients died during perioperation. The median OS was 20.8 months (95% CI: 13.1-25.8 months), and the 1-, 3-, 5-year survival rates were 75.6%, 45.6%, 43.3%, respectively. Conclusion CRS+HIPEC with LBP and TXT to treat PC is a feasible procedure with acceptable safety, and could prolong patients' survival.

     

  • [1] Chua TC, Esquivel J, Pelz JO, et al. Summary of current therapeutic options for peritoneal metastases from colorectal cancer[J]. J Surg oncol, 2013, 107(6): 566-73.
    [2] Sugarbaker PH. Surgical responsibilities in the management of peritoneal carcinomatosis[J]. J Surg oncol, 2010, 101(8): 713-24.
    [3] Glehen O, Osinsky D, Cot te E, et al. Int raperitoneal chemohyperthermia using a closed abdominal procedure and cytoreductive surgery for the treatment of peritoneal carcinomatosis: morbidity and mortality analysis of 216 consecutive procedures[J]. Ann Surg Oncol, 2003, 10(8): 863-9.
    [4] Elias D, Bonnay M, Puizillou JM, et al. Heated intra-operative intraperitoneal oxaliplatin after complete resection of peritoneal carcinomatosis: pharmacokinetics and tissue distribution[J]. Ann Oncol, 2002, 13(2): 267-72.
    [5] El-Kareh AW, Secomb TW. A theoretical model for intraperitoneal delivery of cisplatin and the effect of hyperthermia on drug penetration distance[J]. Neoplasia, 2004, 6(2): 117-27.
    [6] Huang CQ, Feng JP, Yang X, et al. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from colorectal cancer: a case-control study from a Chinese center[J]. J Surg Oncol, 2014, 10 9(7): 730-9.
    [7] Coccolini F, Campanati L, Catena F, et al. Hyperthermic intraperitoneal chemotherapy with cisplatin and paclitaxel in advanced ovarian cancer: a multicenter prospective observational study[J]. J Gynecol Oncol, 2015, 26(1): 54-61.
    [8] Li Y, Zhou YF, Liang H, et al. Expert Consensus on the Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemothe r apy (HIPEC) to Tr e a t Pe r i tone a l Sur f a c e Malignancies[J]. Zhongguo Zhong Liu Lin Chuang, 2015, 42(4): 19 8-206. [李雁, 周云峰, 梁寒, 等. 细胞减灭术加腹腔热灌注 化疗治疗腹膜表面肿瘤的专家共识[J]. 中国肿瘤临床, 2015, 42 (4): 198-206.]
    [9] Tan YN, Yuang Y. Treatment advances of peritoneal metastasis from gastric cancer[J]. Zhong Liu Fang Zhi Yan Jiu, 2015, 42(5): 50 6-10.[谭依诺,袁瑛. 胃癌腹膜转移的治疗进展[J]. 肿瘤防治 研究, 2015, 42(5): 506-10.]
    [10] Ali I, Wani WA, Saleem K, et al. Platinum compouds: a hope for future cancer chemotherapy[J]. Anticancer Agents Med Chem, 20 13, 13(2): 296-306.
    [11] Wheate NJ, Walker S, Craig GE, et al. The status of platinum anticancer drugs in the clinic and in clinical trials[J]. Dalton Trans, 2010, 39(35): 8113-27.
    [12] Peng Y, Liu YE, Ren XC, et al. A phase I clinical trial of dose escalation of lobaplatin in combination with fixed-dose docetaxel for the treatment of human solid tumours that had progressed following chemotherapy[J]. Oncol Lett, 2015, 9(1): 67-74.
    [13] Long GX, Lin JW, Liu DB, et al. Single-arm, multi-centre phase II study of lobaplatin combined with docetaxel for recurrent and metastatic nasopharyngeal carcinoma patients[J]. Oral Oncol, 20 14, 50(8): 712-20.
    [14] Xie CY, Xu YP, Jin W, et al. Antitumor activity of lobaplatin alone or in combination with antitubulin agents in non-small-cell lung cancer[J]. Anticancer Drugs, 2012, 23(7): 698-705.
    [15] Yang XJ, Huang CQ, Suo T, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: final results of a phase Ⅲ randomized clinical trial[J]. Ann Surg Oncol, 20 11, 18(6): 1575-81.
    [16] Sugarbaker PH. Successful management of microscopic residual disease in large bowel cancer[J]. Cancer Chemother Pharmacol, 19 99, 43 Suppl:15-25.
    [17] Jacquet P, Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis[J]. Cancer Treat Res, 1996, 82: 359-74.
    [18] National Cancer Institute: Common Terminology Criteria for Adverse Events version 4.0[EB/OL]. http://ctep.cancer.gov/ protocolDevelopment/electronic_applications/ctc.htm.
    [19] Verwaal VJ, van Ruth S, de Bree E, et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer[J]. J Clin Oncol, 2003, 21(20): 3737-43.
    [20] Tang L, Mei LJ, Yang XJ, et al. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy improves survival of gastric cancer with peritoneal carcinomatosis: evidence from an experimental study[J]. J Transl Med, 2011, 9: 53.
    [21] Spiliotis J, Halkia E, Lianos E, et al. Cytoreductive Surgery and HIPEC in Recurrent Epithelial Ovarian Cancer: A Prospective Randomized PhaseⅢStudy[J]. Ann Surg Oncol, 2015, 22(5): 15 70-5.
    [22] Deng QQ, Huang XE, Ye LH, et al. PhaseⅡtrial of Loubo® (Lobaplatin) and pemetrexed for patients with metastatic breast cancer not responding to anthracycline or taxanes[J]. Asian Pac J Cancer Prev, 2013, 14(1): 413-7.
    [23] Ford H, Gounaris I. Docetaxel and its potential in the treatment of refractory esophagogastric adenocarcinoma[J]. Therap Adv Gastroenterol, 2015, 8(4): 199-205.
    [24] Tan Q, Joshua AM, Saqqar JK, et al. Effect of pantoprazole to enhance activity of docetaxel against human tumor xenografts by inhibiting autophagy[J]. Br J Cancer, 2015, 112(5): 832-40.
    [25] Li XC, Li YH. Clinical study on chemotherapy of lobplatin combined with docetaxel in patients with relapsed ovarian cancer[J]. Zhongnan Da Xue Xue Bao (Yi Xue Ban), 2014, 39 (11): 1131-6. [李新春, 李瑛花. 洛铂联合多西他赛治疗复发 性卵巢癌的疗效[J]. 中南大学学报(医学版), 2014, 39(11): 11 31-6.]
    [26] Zhang YH, Li Y, Chen C, et al. Carcinoembryonic antigen level is related to tumor invasion into the serosa of the stomach: study on 166 cases and suggestion for new therapy[J]. Hepatogastroenterology, 2009, 56(96): 1750-4.
    [27] Nakata B, Hirakawa-YS Chung K, Kato Y, et al. Serum CA125 level as a predictor of peritoneal dissemination in patients with gastric carcinoma[J]. Cancer, 1998, 83(12): 2488-92.
    [28] Polat E, Duman U, Duman M, et al. Preoperative serum tumor marker levels in gastric cancer[J]. Pak J Med Sci, 2014, 30(1): 14 5-9.
    [29] Scaringi S, Kianmanesh R, Sabate JM, et al. Advanced gastric cancer with or without peritoneal carcinomatosis treated with hyperthermic intraperitoneal chemotherapy: a single western center experience[J]. Eur J Surg Oncol, 2008, 34(11): 1246-52.
    [30] Arias F, Herrera-Almario G, Pozo ME, et al. Safety and quality outcomes in peritoneal surface malignancy patients: developing a national center for excellence in Colombia[J]. Ann Surg Oncol, 20 15, 22(5): 1733-8.
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出版历程
  • 收稿日期:  2015-06-04
  • 修回日期:  2015-07-09
  • 刊出日期:  2016-02-24

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