Innovations and challenges in intraperitoneal chemotherapy for peritoneal metastatic carcinoma

Xinying FENG; Bing WANG; Peifeng LIU

doi:10.19401/j.cnki.1007-3639.2024.09.003

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Innovations and challenges in intraperitoneal chemotherapy for peritoneal metastatic carcinoma

Specialists' Commentory | 更新时间：2025-12-31

- Innovations and challenges in intraperitoneal chemotherapy for peritoneal metastatic carcinoma
- China Oncology Vol. 34, Issue 9, Pages: 827-837(2024)
- 作者机构：
  
  1. 上海交通大学医学院附属仁济医院，上海市肿瘤研究所，肿瘤系统医学全国重点实验室，上海 200032
  2. 上海交通大学医学院附属仁济医院中心实验室，上海 2000127
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2024.09.003
  CLC： R730.53
- Received：01 August 2024，
  
  Revised：2024-09-11，
  
  Published：30 September 2024
- 稿件说明：
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Xinying FENG, Bing WANG, Peifeng LIU. Innovations and challenges in intraperitoneal chemotherapy for peritoneal metastatic carcinoma[J]. China Oncology, 2024, 34(9): 827-837.
DOI：

Xinying FENG, Bing WANG, Peifeng LIU. Innovations and challenges in intraperitoneal chemotherapy for peritoneal metastatic carcinoma[J]. China Oncology, 2024, 34(9): 827-837. DOI： 10.19401/j.cnki.1007-3639.2024.09.003.

摘要

腹膜转移癌是指从原发部位扩散至腹膜的恶性肿瘤，常见于胃癌、结直肠癌、卵巢癌及腹膜假黏液瘤（pseudomyxoma peritonei，PMP）等多种癌症类型的晚期阶段。腹膜转移癌的复发率和死亡率高，严重危害人类健康，通常在根治术后或晚期腹膜转移阶段采用以化疗为主的姑息性治疗方案。腹膜转移癌治疗的难点在于缺少靶向治疗药物以及药物较难透过血-腹膜屏障，以致全身治疗效果欠佳。腹腔化疗（intraperitoneal chemotherapy，IPC）作为一种重要的临床治疗手段，在腹膜转移癌的治疗中具有广阔的应用前景。近年来，腹腔热灌注化疗（hyperthermic intraperitoneal chemotherapy，HIPEC）、腹腔加压气溶胶（pressurized intraperitoneal aerosol chemotherapy，PIPAC）等IPC技术的革新和新型药物的出现显著延长了患者的生存期。然而，腹膜转移癌的多样性和复杂性使临床IPC在给药方式、药物类型和剂量等治疗策略上仍然存在差异性和疗效不确定性。尽管已经制定了基于循证医学证据的指南和推荐治疗策略，但是仍需要通过更多的临床试验和更高级别的循证医学证据来进一步支持这些方案。本文对IPC的发展历程和最新进展进行归纳总结，对比分析手术治疗联合传统IPC、HIPEC及PIPAC等治疗手段的疗效，并对近期开展的IPC技术的研究进展进行汇总。此外，在IPC技术的临床应用方面，本文详细阐述其在胃癌、结直肠癌、妇科肿瘤、PMP、胆管癌及胰腺癌等疾病中的应用。针对IPC技术的局限性，提出纳米药物的创新开发有望为腹膜转移癌的治疗提供更安全有效的选择。综上所述，本文通过梳理IPC研究的最新进展、不足和未来发展方向，以期为腹膜转移癌更有效的临床治疗提供可行性方向。

Abstract

Peritoneal metastatic carcinoma refers to the spread of malignant tumors from the primary site to the peritoneum. It is commonly observed in the advanced stages of various cancer types

including gastric cancer

colorectal cancer

ovarian cancer and pseudomyxoma peritonei (PMP). Peritoneal metastatic carcinoma seriously impair human health due to their high recurrence and mortality rates

and palliative treatment based on chemotherapy is usually provided after radical surgery or in the advanced stage of peritoneal metastases. The difficulties in the treatment of peritoneal metastatic carcinoma are the lack of targeted drugs and the difficulty of drugs to cross the blood-peritoneal barrier

resulting in poor systemic effects. Intraperitoneal chemotherapy

as an important therapeutic means

has a broad application prospect in the treatment of peritoneal metastatic carcinoma. In recent years

innovations in intraperitoneal chemotherapy techniques such as hyperthermic intraperitoneal chemotherapy (HIPEC)

pressurized intraperitoneal aerosol chemotherapy (PIPAC) and the development of novel drugs have significantly improved patients' quality of life. The development of novel drugs has significantly improved patient survival. However

the diversity and complexity of these diseases have led to clinical variability and uncertainty in the efficacy of intraperitoneal chemotherapy in terms of treatment strategies such as mode of administration

drug type and dose. Although evidence-based guidelines and recommended treatment strategies have been developed

there is a need to further support these regimens through additional clinical trials and higher levels of evidence-based medicine. This review summarized the development history and recent advances in intraperitoneal chemotherapy

compared and analyzed the treatments such as surgery combined with traditional IPC

HIPEC and PIPAC

and summarized the research progress of recently conducted intraperitoneal chemotherapy techniques; moreover

in terms of the clinical application of intraperitoneal chemotherapy techniques

this paper elaborated on its use in diseases such as gastric cancer

colorectal cancer

gynecological oncology

PMP

cholangiocarcinoma and pancreatic cancer. For the limitations of intraperitoneal chemotherapy technology

it is proposed that the innovative development of nanomedicine is expected to provide a safer and more effective option for the treatment of peritoneal metastatic carcinoma. In conclusion

this review summarized the latest progress

shortcomings and future development of intraperitoneal chemotherapy

with the aim of providing a feasible direction for more effective clinical treatment of peritoneal metastatic carcinoma.

关键词

Keywords

references

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Progress and prospects of CENPA-driven chromosomal instability in breast cancer: mechanisms, prognostic implications, and therapeutic perspectives

Targeted therapy and immunotherapy combined with chemotherapy bring effective response to AFP positive colon cancer patients: a case report and literature review

Research status and progress of third-line treatment for metastatic colorectal cancer

Effectiveness and safety analysis of camrelizumab combined with chemotherapy and targeted therapy in patients with recurrent, metastatic, and treatment-naive advanced cervical cancer: a retrospective cohort study

Research status and prospects of treatment for malignant pleural mesothelioma

Related Author

LU Ye

ZHANG Wenxiang

KONG Xiangyi

FANG Yi

WANG Jing

GAO Jidong

LIU Miao

LI Jinze

Related Institution

Department of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital& Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

Department of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

Department of Pathology, the Fourth Hospital of Hebei Medical University

Department of Gastroenterology, the Fourth Hospital of Hebei Medical University

Department of Oncology, The First Affiliated Hospital of Naval Medical University

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