Clinical efficacy of hyperthermic intraperitoneal chemotherapy plus cytoreductive surgery for peritoneal metastasis of gallbladder cancer
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摘要:
目的 探讨腹腔热灌注化疗（hyperthermic intraperitoneal chemtheropy，HIPEC）治疗胆囊癌伴腹膜转移患者的临床疗效研究。 方法 本文回顾性分析海军军医大学东方肝胆外科医院2015年1月至2018年1月收治的84例胆囊癌合并腹膜转移患者，31例患者给予HIPEC联合细胞减灭术（cytoreductive surgery，CRS）+术后1个月全身化疗为研究组，53例给予细胞减灭术+术后1个月全身化疗为对照组，观察比较两组临床疗效及不良反应发生情况。 结果 研究组中位生存时间为（21.72±2.96）个月，显著长于对照组的（14.93±2.09）个月（P < 0.05）。研究组白细胞减少、血红蛋白减少、血小板减少、胃肠道反应、肝功能损伤和肾功能损伤较对照组无显著性差异（P>0.05）。 结论 HIPEC治疗进展期胆囊癌临床疗效显著，可延长患者生存时间，不良反应较小，值得推广应用。 Abstract:Objective To investigate the clinical efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) for gallbladder cancer with peritoneal metastasis. Methods Data of 84 patients, who were admitted to Shanghai Eastern Hepatobiliary Surgery Hospital from January 2015 to January 2018, were retrospectively analyzed. Of the total patients, 31 received HIPEC combined with cytoreductive surgery (CRS) plus postoperative systemic chemotherapy one month after surgery as the study group (Group A), and the other 53 underwent CRS plus postoperative systemic chemotherapy one momth after surgery as the control group (Group B). The clinical effects and adverse reactions in the two groups were observed and compared. Results The median survival time in the Group A was (21.72±2.96) months, significantly longer than that of (14.93±2.09) months in Group B (P < 0.05). There were no statistically significant differences in leukopenia, hemoglobinemia, thrombocytopenia, gastrointestinal reaction, liver function injury and renal function injurybetween the two groups (P>0.05). Conclusions HIPEC has significant clinical efficacy for gallbladder cancer with peritoneal metastasis. HIPEC can prolong the survival time and have less side effects. -
表 1 胆囊癌患者的主要临床病理特征
例 
表 2 CRS+HIPEC治疗患者的相关治疗参数
表 3 胆囊癌伴腹膜转移预后的单因素分析
表 4 胆囊癌伴腹膜转移预后的多因素分析
表 5 两组不良反应比较
例（%） 
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[1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017[J]. CA Cancer J Clin, 2017, 67(1):7-30. doi: 10.3322/caac.21387 [2] Hundal R, Schaffer EA. Gallbladder cancer:epidemiology and outcome[J]. Clin Epidemiol, 2014, 6:99-109. http://cn.bing.com/academic/profile?id=a330e677d7a7dd6f874f8e8bf4bc7ae9&encoded=0&v=paper_preview&mkt=zh-cn [3] Radtke A, Königsrainer A. Surgical therapy of cholangiocarcinoma[J]. Visc Med, 2016, 32(6):422-426. doi: 10.1159/000452921 [4] Wernberg JA, Lucarelli DD. Gallbladder cancer[J]. Surg Clin North Am, 2014, 94(2):342-360. http://d.old.wanfangdata.com.cn/Periodical/zhgdwk201712020 [5] Sasaki E, Nagino M, Ebata T, et al. Immunohistochemically demonstrated lymph node micrometastasis and prognosis in patients with gallbladder carcinoma[J]. Ann Surg, 2006, 244(1):99-105. doi: 10.1097/01.sla.0000217675.22495.6f [6] 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. doi: 10.3969/j.issn.1000-8179.20150013 [7] 郝希山.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导读[J].中国肿瘤临床, 2015, 42(4):197. doi: 10.3969/j.issn.1000-8179.20150184 [8] Yonemura Y, Kawamura T, Bandou E, et al. The natural history of free cancer cells in the peritoneal cavity[J]. Recent Results Cancer Res, 2007, 169:11-23. http://cn.bing.com/academic/profile?id=cf8f35fd6d93aff889e5b30f53a2b73d&encoded=0&v=paper_preview&mkt=zh-cn [9] Arjona-Sanchez A, Muñoz-Casares C, Ortega-Salas R, et al. Long-term survival with peritoneal mucinous carcinomatosis from intraductal mucinous papillary pancreatic carcinoma treated with complete cytoreduction and hyperthermic intraperitoneal chemotherapy[J]. Int J Hyperthermia, 2014, 30(6):408-411. doi: 10.3109/02656736.2014.952251 [10] Macrì A, Arcoraci V, Belgrano V, et al. Short-term outcome of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy:preliminary analysis of a multicentre study[J]. Anticancer Res, 2014, 34(10):5689-5693. http://cn.bing.com/academic/profile?id=3259d327554a07caad388172f28b6eee&encoded=0&v=paper_preview&mkt=zh-cn [11] Yang XJ, Huang CQ, Suo T, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patien with peritoneal carcinomatosis from gastric cancer:final results of a phase HI randomized clinical trial[J]. Ann Surg Oncol, 2011, 18(6):1575-1581. doi: 10.1245/s10434-011-1631-5 [12] Cashin PH, Graf W, Nygren P, et al. Intraoperative hyperthermic versus postoperative normothermic intraperitoneal chemotherapy for colonic peritoneal carcinomatosis:a case-control study[J]. Ann Oncol, 2012, 23(3):647-652. doi: 10.1093/annonc/mdr301 [13] 李鑫宝, 林育林, 姬忠贺, 等.肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜假黏液瘤182例分析[J].中国肿瘤临床, 2018, 45(18):943-949. doi: 10.3969/j.issn.1000-8179.2018.18.607 [14] 黄超群, 周云峰, 谢丛华, 等.细胞减灭术加腹腔热灌注化疗治疗结直肠癌腹膜转移癌病例对照研究[J].中国肿瘤临床, 2013, 40(16):979-983. doi: 10.3969/j.issn.1000-8179.20130155 [15] Hakia E, Efstathiou E, Rogdakis A, et al. Digestive fistulas after cytoreductive surgery & HIPEC in peritoneal carcinomatosis[J]. J BUON, 2015, 20(Suppl 1):S60-S63. http://cn.bing.com/academic/profile?id=15b35adc227fe698898bc4238bb6d429&encoded=0&v=paper_preview&mkt=zh-cn [16] 何坤, 胡泽民, 阮嘉后, 等.肝切除联合腹腔热灌注化疗在肝癌自发破裂出血中的应用[J].肝胆胰外科杂志, 2017, 29(6):464-467. http://d.old.wanfangdata.com.cn/Periodical/gdywkzz201706007 -
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