持续高热腹腔灌注化疗临床应用现状

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目的阐述持续高热腹腔灌注化疗临床应用现状。方法结合文献讨论持续高热腹腔灌注化疗在常见局部晚期腹腔恶性肿瘤中的治疗作用和应用现状,并总结了持续高热腹腔灌注化疗在应用中的常见并发症。结果在局部晚期结直肠癌治疗中,外科手术联合CHPP的治疗明显优于手术加全身化疗的效果,3年生存率(3-yOS)可达25%~39%。局部晚期胃癌患者也从手术加CHPP治疗中获益,3-yOS为20%~73%。在局部晚期卵巢癌治疗中,CHPP仅推荐应用于一线含铂类方案化疗治疗失败患者的二线治疗。腹腔假黏液腺瘤是CHPP治疗的经典适应证,完全手术切除后联合CHPP治疗,5-yOS可达86%~97%。经CHPP治疗后,恶性腹膜间皮瘤的中位生存期可从12~17个月提高到34~67个月。CHPP相关并发症的发生率大致为27%~56%,常见的由CHPP引起的并发症如血液学毒性,肝、肾功能损害,肠粘连、肠梗阻,尿储留,盆腹腔感染,吻合口炎等等。结论近年来CHPP在临床应用方面得到了较快的发展,并取得了较好的临床疗效。 Objective To describe the clinical application of continuous high intraperitoneal perfusion chemotherapy. Methods Combined with the literature discuss the treatment effect and application status of continuous high intraperitoneal perfusion chemotherapy in common locally advanced abdominal malignancy, and summarize the common complications in the application of continuous high intraperitoneal perfusion chemotherapy. Results In the treatment of locally advanced colorectal cancer, the combination of surgery and CHPP was superior to surgery and systemic chemotherapy. The 3-year survival rate (3-yOS) was 25% -39%. Patients with locally advanced gastric cancer also benefit from surgery and CHPP treatment, 3-yOS 20% to 73%. In the treatment of locally advanced ovarian cancer, CHPP is only recommended for second-line treatment in patients with first-line platinum-containing chemotherapy failure. Peritoneal pseudomyxoma is a classic indication for the treatment of CHPP, completely combined with CHPP after surgical resection, 5-yOS up to 86% to 97%. After CHPP treatment, the median survival of malignant peritoneal mesothelioma from 12 to 17 months increased to 34 to 67 months. The incidence of CHPP-related complications is roughly 27% -56%. Common complications caused by CHPP include hematologic toxicity, impaired liver and renal function, intestinal adhesion, intestinal blockage, urinary retention, pelvic infection and anastomosis Inflammation and so on. Conclusion In recent years, CHPP has achieved rapid development in clinical application and achieved good clinical efficacy.
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