Strategies of chemotherapy for peritoneal metastasis of gastrointestinal cancer.
10.3760/cma.j.cn.441530-20201105-00591
- Author:
Min SHI
1
;
Jun ZHANG
1
Author Information
1. Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, State Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University, Shanghai 200025, China.
- Publication Type:Journal Article
- Keywords:
Assessment;
Chemotherapy;
Gastrointestinal neoplasms;
Peritoneal metastasis;
Prevention;
Treatment
- MeSH:
Antineoplastic Combined Chemotherapy Protocols;
Combined Modality Therapy;
Gastrointestinal Neoplasms/drug therapy*;
Humans;
Hyperthermia, Induced;
Peritoneal Neoplasms/drug therapy*;
Peritoneum;
Prospective Studies;
Stomach Neoplasms/therapy*
- From:
Chinese Journal of Gastrointestinal Surgery
2021;24(3):214-219
- CountryChina
- Language:Chinese
-
Abstract:
Peritoneal metastasis of gastrointestinal cancer is an independent factor that seriously affects the prognosis of patients. The "seed-soil" theory is considered to be the main theory to explain peritoneal metastasis. Because of the small size of peritoneal metastatic nodules at the initial stage, early diagnosis is particularly difficult, therefore, the risk assessment of peritoneal metastasis is very important. Recently, the diagnosis methods have gradually developed from clinicopathological factors to cytology and molecular level. In addition, the integrated assessment of multiple groups including radiomics further enriches the accurate diagnosis of peritoneal metastasis. Peritoneal metastasis is a big challenge in the treatment of gastrointestinal cancer which may also lead to refractory malignant ascites, intestinal obstruction, cachexia and other related complications. At present, the treatment is based on systemic chemotherapy. The combination of surgery, intraperitoneal chemotherapy and HIPEC is an effective treatment for peritoneal metastasis of gastrointestinal cancer. How to enrich peritoneal metastasis patients with potential benefits, how to determine the timing of conversion surgery, how to further optimize the existing treatment plan, especially how to formulate treatment plan for patients after conversion surgery, call for improved study design and prospective randomized controlled trials. The goal of continuous efforts is to effectively prolong the survival of gastrointestinal cancer trials patients with peritoneal metastasis.
