卵巢癌腹膜转移腹腔化疗的研究进展

卵巢癌早期临床症状不明显,确诊时多为晚期,约75%的患者发生腹膜转移,手术难以完全清除肿瘤病灶,治疗效果差,易复发,死亡率高居所有妇科恶性肿瘤首位。晚期卵巢癌腹膜转移患者常伴有不同程度的癌性腹腔积液,多以控制局部发展为主要治疗目标,因此肿瘤细胞减灭术及腹腔注射化疗药物成为此类患者的主要治疗方式。与常规静脉应用化疗药物相比,腹腔热灌注化疗、加压腹腔气溶胶化疗等腹腔化疗方式在缩小肿瘤体积、控制恶性腹腔积液方面有突出优势,能够显著延长卵巢癌患者无复发生存期、无病生存期及总生存期,同时减轻治疗相关不良反应,提高患者的生存质量。综述卵巢癌腹腔化疗及其临床研究进展,以期为临床治疗提供参考。

Research Progress of Intraperitoneal Chemotherapy for Peritoneal Metastases of Ovarian Cancer

The early clinical symptoms of ovarian cancer are not obvious, and most of the patients have been at the advanced stage when they were diagnosed. About 75% of patients have the peritoneal metastases of ovarian cancer which are difficult to be resected completely by surgery. The therapeutic effect of metastasizing neoplasms is poor, and neoplasm is prone to recur. The mortality rate is the first of all gynecological malignancies. Patients with the advanced ovarian cancer and the peritoneal metastasis are often accompanied by different degrees of cancerous peritoneal effusion, and the main treatment goal is to control local development. Therefore, cytoreductive surgery and intraperitoneal injection of chemotherapy drugs are of important treatment methods for those patients with peritoneal metastasis of ovarian cancer. Compared with the conventional intravenous chemotherapy, intraperitoneal chemotherapy methods such as hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC) have outstanding advantages in reducing tumor volume and controlling malignant peritoneal effusion, which can significantly prolong recurrence-free survival (RFS), disease-free survival (DFS) and overall survival (OS) of patients. Meanwhile, the intraperitoneal chemotherapy methods reduce treatment-related adverse reactions, and improve life quality of patients. This paper reviews the intraperitoneal chemotherapy methods of the peritoneal metastases of ovarian cancer and the research progress, in order to provide a reference for clinical treatment.