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The combination of complete cytoreductive surgery and perioperative intraperitoneal chemotherapy provides the only chance for long-term survival for selected patients diagnosed with a variety of peritoneal neoplasms,either primary or secondary to digestive or gynecologic malignancy.Hyperthermic intraperitoneal chemotherapy (HIPEC) delivered in the operating room once the cytoreductive surgical procedure is fi nalized,constitutes the most common form of administration of perioperative intraperitoneal chemotherapy.This may be complemented in some instances with early postoperative intraperitoneal chemotherapy (EPIC).HIPEC combines the pharmacokinetic advantage inherent to the intracavitary delivery of certain cytotoxic drugs,which results in regional dose intensification,with the direct cytotoxic effect of hyperthermia.Hyperthermia exhibits a selective cell-killing effect in malignant cells by itself,potentiates the cytotoxic effect of certain chemotherapy agents and enhances the tissue penetration of the administered drug.The chemotherapeutic agents employed in HIPEC need to have a cell cycle nonspecific mechanism of action and should ideally show a heat-synergistic cytotoxic effect.Delivery of HIPEC requires an apparatus that heats and circulates the chemotherapeutic solution so that a stable temperature is maintained in the peritoneal cavity during the procedure.An open abdomen (Coliseum) or closed abdomen technique may be used,with no signif icant differences in eff icacy proven to date.Specif ic technical training and a solid knowledge of regional chemotherapy management are required.Concerns about safety of the procedure for operating room personnel are expected but are manageable if universal precautions and standard chemotherapy handling procedures are used.Different HIPEC drug regimens and dosages are currently in use.A tendency for concurrent intravenous chemotherapy administration (bidirectional chemotherapy,so-called 'HIPEC plus') has been observed in recent years,with the aim to further enhance the cy
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篇名 Hyperthermic intraperitoneal 化疗: 基本原理和技术
来源期刊 世界胃肠肿瘤学杂志:英文版(电子版) 学科 医学
关键词 HYPERTHERMIA Intracavitary CHEMOTHERAPY PERITONEAL NEOPLASMS PERITONEAL CARCINOMATOSIS Cytoreductive surgery
年,卷(期) 2010,(2) 所属期刊栏目
研究方向 页码范围 68-75
页数 8页 分类号 R735.3
字数 语种
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HYPERTHERMIA
Intracavitary
CHEMOTHERAPY
PERITONEAL
NEOPLASMS
PERITONEAL
CARCINOMATOSIS
Cytoreductive
surgery
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世界胃肠肿瘤学杂志:英文版(电子版)
月刊
1948-5204
北京市朝阳区东四环中路62号楼远洋国际中
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664
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