Intraperitoneal Chemotherapy for Gastric Cancer with Peritoneal Carcinomatosis: Is HIPEC the Only Answer?

• 作者: Betty Tsz-Ting Law Dora Lai-Wan Kwong Ka-On Lam Simon Ying-Kit Law
• 来源期刊: 化疗(英文)
• 学科: 医学
• 关键词: Gastric Cancer Peritoneal CARCINOMATOSIS Hyperthermic INTRAPERITONEAL CHEMOTHERAPY (HIPEC) NEOADJUVANT Intraperitoneal/Systemic CHEMOTHERAPY (NIPS) Cytoreductive Surgery
• 年，卷（期）: hlyw,（2）
• 页码范围: 11-19
• 页数: 9页
• 分类号: R73

摘要

Gastric cancer with peritoneal carcinomatosis is notorious for its dismal prognosis. While the pathophysiology of peritoneal dissemination is still controversial, the rapid downhill course is universal. Patients usually suffer abdominal distension, intestinal obstruction and various complications before they succumb after a median of 3 - 6 months. Although not adopted in most international treatment guidelines, intraperitoneal chemotherapy has growing evidence compared with conventional systemic chemotherapy for the treatment of peritoneal carcinomatosis. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is well-established for clinical benefit but is technically demanding with substantial treatment-related morbidities and mortality. On the other hand, normothermic intraperitoneal chemotherapy in the form of bidirectional neoadjuvant treatment is promising with various newer chemotherapeutic agents. Regardless of the treatment technique applied, the essential element of success is meticulous patient selection and availability of expertise. Future direction is along the line of personalized treatment with the application of translational science.