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13 december 2015: Bron: BMC Cancer. 2012; 12: 526. Published online 2012 Nov 16. 

Aanvullend op onderstaand artikel is in 2012 deze meta analyse gepubliceerd die ook aangeeft dat een Hypec operatie (dus met hyperthermie - verwarmde chemo - tijdens de operatie) een betere kans op overleving geeft dan alleen operatie en chemo bij maagkanker. in vergelijking met alleen operatie en / of alleen chemo postoperatief Er moet voor deze behandeling wel goed geselecteerd worden op lichamelijke gesteldheid van de patiënt om ernstige complicaties tijdens de Hypec te voorkomen, maar dat geberut in principe altijd al bij een Hypec operatie. Hier de grafiek van de studies die zijn opgenomen in deze meta analyse en de resultaten daarvan in een grafiek weergegeven

hypec bij maagkanker 2

Het volledige studierapport: Benefits of hyperthermic intraperitoneal chemotherapy for patients with serosal invasion in gastric cancer: a meta-analysis of the randomized controlled trials is gratis in te zien. Het abstract hiervan staat onderaan dit artikel

29 april 2005: Bron: Ai Zheng. 2005 Apr;24(4):478-82.

Een combinatiebehandeling van operatie, chemo en inwendige lokale hyperthermie geeft significant meer 2 en 3 jaars overlevingen bij maagkanker t.o.v. alleen operatie met chemo of operatie met alleen gedistilleerd water direct na operatie gegeven. Ook bleek in de groep met hyperthermie als aanvulling significant minder leveruitzaaiïngen op te treden dan in controlegroep. Dit blijkt uit gerandomiseerde studie bij 156 maagkankerpatiënten verdeeld over drie groepen. Groep 1 kreeg combinatie behandeling van operatie en chemo inclusief hyperthermie, groep 2 kreeg chemo direct na operatie en tijdens operatie en groep 3 kreeg gedistilleerd water tijdens en na operatie. Hier de resultaten en conclusie zo goed als letterlijk vertaald in het Nederlands:

RESULTATEN: De 2-jaars overlevingscijfers van de combinatiegroep 1 waren significant beter dan van de controlegroep (88.4% vs. 65.2%, P < 0.05). De 3-jaars overlevingscijfers van groep 1 was significant beter dan van beide andere groepen, (red: al zit er tussen groep 2 en controlegroep opvallend weinig verschil.) (71.1% vs. 50.0% tussen groep 1 en groep 2 , en 71,1% van groep 1 t.o.v. 45,6% van controlegroep. P < 0.05). Het later optreden van leveruitzaaiïngen was vooral in groep 1 maar ook in groep 2 significant lager dan in de controlegroep. (7.7%, en 10.2% vs. 27.3%, P < 0.05).

Conclusie: Een combinatietherapie van intra-operatieve chemo en hyperthermie en snel gegeven postoperatieve chemo kan worden gebruikt om postoperatieve leveruitzaaiïngen te voorkomen.

Achtereenvolgens het abstract van de nieuwste studie en daaronder het abstract van andere studie met zelfde positieve effecten van zelfde aanpak van combinatie van operatie, chemo en hyperthermie gepubliceerd in 2004

Ai Zheng. 2005 Apr;24(4):478-82

[Efficacy of Intraoperative Hypotonic Peritoneal Chemo-hyperthermia Combined with Early Postoperative Intraperitoneal Chemotherapy on Gastric Cancer.]

[Article in Chinese]

Wei G, Fang GE, Bi JW, Shen XJ, Nie MM, Xue XC, Hua JD.

Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, P. R. China. wgdr2004@163.com.

BACKGROUND & OBJECTIVE: Abdominal recurrence from exfoliated cancer cells contributes a lot to treatment failure of advanced gastric cancer. Intraperitoneal chemotherapy, which has been proved effective in eliminating exfoliated cancer cells in abdominal cavity, is a hot topic on treatment of gastric cancer. This study was to explore application of combined therapy of intraoperative hypotonic peritoneal chemo-hyperthermia and early postoperative intraperitoneal chemotherapy to gastric cancer.

METHODS: A total of 156 gastric cancer patients were randomized into 3 groups, and underwent the combined therapy (treatment group 1), intraoperative chemotherapy (treatment group 2), and peritoneal lavage with distilled water (control group), respectively.

RESULTS: The 2-year survival rate of treatment group 1 was significantly higher than that of control group (88.4% vs. 65.2%, P < 0.05). The 3-year survival rate of treatment group 1 was significantly higher than those of treatment group 2, and control group (71.1% vs. 50.0%, and 45.6%, P < 0.05). Occurrence of liver metastasis was significantly lower in treatment groups 1 and 2 than in control group (7.7%, and 10.2% vs. 27.3%, P < 0.05).

CONCLUSIONS: Combined therapy of intraoperative hypotonic chemo-hyperthermia and early postoperative intraperitoneal chemotherapy is effective for gastric cancer. Intraperitoneal chemotherapy can be used to prevent postoperative liver metastasis of gastric cancer.

PMID: 15820074 [PubMed - in process]

Zhonghua Zhong Liu Za Zhi. 2004 Apr;26(4):247-9.

[Postoperative intraperitioneal hyperthermic chemoperfusion combined with intravenous chemotherapy for 82 advanced gastric cancer patients]

[Article in Chinese]

Zuo Y, Xu M, Shen D, Lu WD, Lu JF.

First People's Hospital, Zhangjiagang 215600, China.

OBJECTIVE: To evaluate the efficacy of postoperative intraperitoneal hyperthermic chemoperfusion (IHCP) combined with intravenous chemotherapy for advanced gastric cancer.

METHODS: Eighty-two patients with stage II - IV gastric cancer were postoperatively randomized into two groups; 46 patients in treatment group who received IHCP combined with intravenous chemotherapy for three times and 36 patients in control group who received intravenous chemotherapy only for six times. All patients in the two groups received the same chemo-regimen LFAP (CF + 5-Fu + THP or MIT + PDD) 21 - 28 days after operation.

RESULTS: The 1-year survival rate was 98% (45/46) in the treatment group and 94% (34/36) in the control group without any significant difference (P > 0.05). The 3-year survival rate was 83% (38/46) in the treatment group and 61% (22/36) in the control group with significant difference (P < 0.05). Gastrointestinal reaction in the treatment group was significantly decreased compared with in the control group (37% vs 80%, P < 0.01), whereas no statistically significant difference was noted in bone marrow suppression (P > 0.05).

CONCLUSION: Intraperitoneal hyperthermic chemoperfusion combined with intravenous chemotherapy can prolong survival and reduce gastrointestinal side-effect which provides an effective treatment option for advanced gastric cancer.

Randomized Controlled Trial
PMID: 15312391 [PubMed - indexed for MEDLINE]

Our meta-analysis demonstrated that HIPC may improve the overall survival rate for patients who receive resection for advance gastric cancer potentially, and help to prevent peritoneal local recurrence among patients with serosal invasion in gastric cancer.

BMC Cancer. 2012 Nov 16;12:526. doi: 10.1186/1471-2407-12-526.

Benefits of hyperthermic intraperitoneal chemotherapy for patients with serosal invasion in gastric cancer: a meta-analysis of the randomized controlled trials.

Abstract

BACKGROUND:

In this meta-analysis we aimed to determine the effectiveness and safety of hyperthermic intraperitoneal chemotherapy (HIPC) for patients with advanced gastric cancer who underwent gastrectomy.

METHODS:

In accordance with standard meta-analysis procedures, our study included patients who underwent resection for advanced gastric cancer and were randomly allocated to receive either hyperthermic intraperitoneal chemotherapy or control. We searched PubMed (up to November 2011), EMBASE (up to November 2011), Cochrane Database of Systematic Reviews (CDSR), and Cochrane Central Register of Controlled Trials (CCTR) (up to November 2011). Both published and unpublished trials were included in the analysis, and no search restrictions were imposed. There was no language restriction. The results were analyzed using RevMan 5.1 software, which was provided by Cochrane Collaboration.

RESULTS:

There were ten randomized controlled trials included in the analysis. A total of 1062 patients with gastric cancer in these studies were divided into the HIPC group (n = 518) and control group (n = 544). A significant improvement in survival was observed in the HIPC groups compared to the control group in the mitomycin C (MMC) subgroup (RR = 0.75, 95%CI 0.65-0.86; P < 0.00001) and the 5-FU group (RR = 0.69, 95%CI 0.52-0.90; P < 0.00001); the total RR was 0.73 (95%CI 0.64-0.83; P < 0.00001). Our findings indicated that HIPC potentially exhibited a lower peritoneal recurrence rate in the HIPC group compared to the control group (RR = 0.45, 95%CI 0.28-0.72; P = 0.001).

CONCLUSIONS:

Our meta-analysis demonstrated that HIPC may improve the overall survival rate for patients who receive resection for advance gastric cancer potentially, and help to prevent peritoneal local recurrence among patients with serosal invasion in gastric cancer.

PMID:
23153379
[PubMed - indexed for MEDLINE]
PMCID:
PMC3551633

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Articles from BMC Cancer are provided here courtesy of BioMed Central

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