新辅助腹腔内联合全身化疗转化治疗胃癌腹膜转移的研究进展

Research progress of neoadjuvant intraperitoneal-systemic chemotherapy for conversion therapy of peritoneal metastasis in gastric cancer

  • 摘要: 我国胃癌腹膜转移具有发生率高、分期晚、预后差的特点,转化治疗理念的提出为晚期胃癌患者带来了希望。胃癌腹膜转移的转化治疗,旨在通过化疗等手段,使胃癌原发灶降期的同时,腹膜转移灶也得到有效控制,进而施行根治性胃癌切除术,以延长晚期胃癌患者的生存时间和改善患者生命质量。转化治疗方法中,全身系统化疗是核心,腹腔局部化疗作为补充,而新辅助腹腔内联合全身化疗(NIPS)因综合了两者的优势,被认为是最具有前景的转化治疗方法。近年来,关于NIPS转化治疗胃癌腹膜转移的临床研究较多,笔者综述其临床应用经验,以期为临床研究和临床实践提供参考。

     

    Abstract: In China, peritoneal metastasis of gastric cancer has main characteristics of high incidence, late staging and poor prognosis. However, the proposal of conversion therapy has brought hope to patients. Conversion therapy of peritoneal metastasis in gastric cancer is a novel concept, which aims at down-staging of the gastric cancer′s primary lesion and effectively controlling the peritoneal metastases at the same time through valid chemotherapy and other means. Then the surgeons strive for performing radical gastrectomy and lymph node dissection (D2) to prolong survival time of the patients with advanced gastric cancer and improve their life quality. Systemic chemotherapy is the core of the methods of conversion therapy, while the local intraperitoneal chemotherapy can be used as a supplement. Neoadjuvant intraperitoneal-systemic chemotherapy (NIPS) is the most promising technique as conversion therapy due to the comprehensive advantages of the systemic chemotherapy and local intraperitoneal chemotherapy. In recent years, there were many clinical studies reporting NIPS for conversion therapy of peritoneal metastasis in gastric cancer. Therefore, this paper systematically reviews experiences of clinical application in order to provide references for clinical practice of conversion therapy in gastric cancer.

     

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