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细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜转移癌 总被引:1,自引:0,他引:1
目的 观察细胞减灭术(CRS)加腹腔热灌注化疗(HIPEC)治疗胃癌腹膜转移癌(PC)的疗效和安全性.方法 取成年雄性新西兰大白兔42只,将VX2癌细胞注入胃窦部黏膜下,制成溃疡型胃癌PC模型,随机分为空白组(n=14)、单纯CRS组(n=14)、CRS+HIPEC组(n=14).种瘤后第8~9天行治疗,HIPEC药物为多西紫杉醇(10 mg/只)、卡铂(40 mg/只),42 ℃腹腔灌注30 min.主要疗效指标为生存期,次要疗效指标为体质量、生化指标及安全性.结果 模型制作成功率100%(42/42).空白组动物生存期18~30 d(中位数24 d);单纯CRS组20~40 d(中位数27 d);CRS+HIPEC组23~55 d(中位数46 d)(单纯CRS组比空白组比较,P>0.05;CRS+HIPEC组比单纯CRS组,P<0.01).与CRS组比较,HIPEC至少能使生存期延长70%.体质量变化趋势提示HIPEC可延缓肿瘤所致的体质量减轻.各组动物种瘤前、术前及术后第8天外周血细胞计数及血生化指标差异无统计学意义(P>0.05).结论 对胃癌PC大动物模型,CRS不能改善预后,而CRS+HIPEC能显著延长生存期,安全可行.Abstract: Objective To study the efficacy and safety of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) to treat rabbit model of gastric cancer with peritoneal carcinomatosis (PC).Methods VX2 tumor cells were injected into the gastric submucosa of 42 adult male New Zealand rabbits using a laparotomic implantation technique,to construct rabbit model of gastric cancer with PC.The rabbits were randomly divided into three groups:control group (n = 14),CRS group (n = 14),and CRS + HIPEC group (n = 14 ).The rabbits in control group were observed for natural course of disease progression.Treatments were initiated 8 or 9 days after inoculation of tumor cells,including optimal removal of tumor nodules in CRS group,and maximal removal of tumor nodules and heperthermic chemoperfusion in the CRS + HIPEC group with docetaxel (10 mg/rabbit ) and carboplatin (40 mg/rabbit) at 42 ℃ for 30 min.The primary endpoint was overall survival.The secondary endpoints were body weight,biochemistry,major organ functions and serious adverse events.Results The success rates of rabbit PC model were 100% (42/42).The clinicopathological feature of the model was similar to peritoneal carcinomatosis in human.Overall survival was 18-30 days ( median 24 days) in control group,20-40 days ( median 27 days) in CRS group,and 23-55 days ( median 46 days) in CRS plus HIPEC group ( CRS alone group VS control group,P > 0.05;CRS + HIPEC group vs pure CRS group,P < 0.01 ).As compared with CRS only or control groups,HIPEC could extend the overall survival by at least 70%.At the baseline,on the day of surgery and 7 days after surgery,the count of peripheral blood cells,liver and renal functions,and biochemistry parameters were all comparable.Serious adverse events occurred in 0 animal in control group,2 animals in CRS group including 1 animal died of anesthesia overdose and another 1died of postoperative hemorrhage,and 3 animals in CRS + HIPEC group including 1 animal died of anesthesia overdose,and 2 died of diarrhea 23 and 27 days after operation.Conclusion For rabbit model of gastric cancer PC,CRS alone could not bring benefit while CPS + HIPEC with docetaxel and cisplatin could significantly prolong the survival with a acceptable safety. 相似文献
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腹盆腔恶性肿瘤局域性进展往往形成腹膜癌,患者的中位生存期不足6个月[1].对于腹膜癌尚无标准治疗方案,为探讨对腹膜癌的治疗新模式,我们在小动物腹膜癌模型证明腹腔内化疗能延长宿主生存期的基础上,又用兔VX2瘤株建立大动物腹膜癌模型,并鉴定其自然临床病理特征. 相似文献
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腹盆腔恶性肿瘤局域性进展往往形成腹膜癌,患者的中位生存期不足6个月[1].对于腹膜癌尚无标准治疗方案,为探讨对腹膜癌的治疗新模式,我们在小动物腹膜癌模型证明腹腔内化疗能延长宿主生存期的基础上,又用兔VX2瘤株建立大动物腹膜癌模型,并鉴定其自然临床病理特征. 相似文献
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腹盆腔恶性肿瘤局域性进展往往形成腹膜癌,患者的中位生存期不足6个月[1].对于腹膜癌尚无标准治疗方案,为探讨对腹膜癌的治疗新模式,我们在小动物腹膜癌模型证明腹腔内化疗能延长宿主生存期的基础上,又用兔VX2瘤株建立大动物腹膜癌模型,并鉴定其自然临床病理特征. 相似文献
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腹盆腔恶性肿瘤局域性进展往往形成腹膜癌,患者的中位生存期不足6个月[1].对于腹膜癌尚无标准治疗方案,为探讨对腹膜癌的治疗新模式,我们在小动物腹膜癌模型证明腹腔内化疗能延长宿主生存期的基础上,又用兔VX2瘤株建立大动物腹膜癌模型,并鉴定其自然临床病理特征. 相似文献
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结直肠癌局域性进展可形成腹膜癌,大约10%的患者初诊即发现腹膜癌,有4%~19%的患者在根治术后随访期发生腹膜癌,25%~35%的复发患者以腹膜癌为唯一表现。全身化疗对此类腹膜癌只是姑息性治疗,中位生存期不足6个月。缩瘤术加腹腔热灌注化疗则可清除宏观和微观癌细胞。荷兰癌症中心的Ⅰ、Ⅱ、Ⅲ期临床试验总结分析表明,接受完全缩瘤术加腹腔热灌注化疗者的中位生存期可达42.9个月,1、3、5年生存率分别是95%、56%和43%,明显高于传统治疗方法,已成为英国、法国、意大利、荷兰、西班牙和澳大利亚等国的标准治疗。 相似文献
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腹膜癌(peritoneal carcinomatosis,PC)是腹膜表面播散性生长的一类局部区域性肿瘤,常见于胃肠道恶性肿瘤腹膜转移,它被认为是一种终末期疾病,既往常采用姑息性治疗。细胞减灭术(cytoreductive surgery,CRS)加术中、术后早期腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC),联合围手术期系统化疗的综合治疗策略是目前治疗PC的标准方案,可降低腹膜肿瘤复发率、延长患者生存时间,并取得了一定的临床疗效。本文就腹腔热灌注化疗在胃肠道恶性肿瘤腹膜转移中的应用进行概述。 相似文献
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