2022年PSOGI国际共识关于腹腔恶性肿瘤HIPEC方案:上皮性卵巢癌。
The 2022 PSOGI International Consensus on HIPEC Regimens for Peritoneal Malignancies: Epithelial Ovarian Cancer.
发表日期:2023 Aug 10
作者:
Aditi Bhatt, Olivier Glehen, Oliver Zivanovic, Donal Brennan, Cedric Nadeau, Willemien Van Driel, Naoual Bakrin
来源:
ANNALS OF SURGICAL ONCOLOGY
摘要:
我们报告了关于上皮性卵巢癌(EOC)的高温腹腔化疗(HIPEC)方案的国际共识的结果,其中包括以下目标:定义HIPEC的适应证,确定EOC中每种适应证最适合的HIPEC方案,明确HIPEC未来研究的方向,为HIPEC围手术期护理的某些方面提供建议。方法:使用著名的Delphi技术进行两轮投票。涉及三类问题:基于证据的建议[使用Grades of Recommendation, Assessment, Development, and Evaluation (GRADE)系统以及病人、干预、对照和结果(PICO)方法],意见调查和研究建议。在第一轮中,108位专家中有73位(67.5%)回应,并在第二轮中有68位(62.9%)回应。对于34/38(94.7%)个问题达成了共识。然而,只有6/38(15.7%)个问题达到了强烈的正面共识,适合纳入常规护理。在综合细胞切除术(CRS)之后进行HIPEC获得了强烈的正面推荐,值得纳入常规护理。单一药物顺铂是唯一被推荐用于常规护理的药物,而OVHIPEC-1则是最受欢迎的方案。专家组建议进行至少60分钟的HIPEC,并建议将腹腔内温度维持在41°C以上。对于顺铂的HIPEC,应该使用亚硫酸钠进行肾脏保护。此次共识的结果将指导关于HIPEC适应证、选择和各种参数的临床决策,并填补当前知识的空白。这些结果应当成为设计未来关于EOC中HIPEC的临床试验的基础。© 2023年。外科肿瘤学会。
We report the results of an international consensus on hyperthermic intraperitoneal chemotherapy (HIPEC) regimens for epithelial ovarian cancer (EOC) performed with the following goals: To define the indications for HIPEC To identify the most suitable HIPEC regimens for each indication in EOC To identify areas of future research on HIPEC To provide recommendations for some aspects of perioperative care for HIPEC METHODS: The Delphi technique was used with two rounds of voting. There were three categories of questions: evidence-based recommendations [using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system with the patient, intervention, comparator, and outcome (PICO) method], an opinion survey, and research recommendations.Seventy-three (67.5%) of 108 invited experts responded in round I, and 68 (62.9%) in round II. Consensus was achieved for 34/38 (94.7%) questions. However, a strong positive consensus that would lead to inclusion in routine care was reached for only 6/38 (15.7%) questions. HIPEC in addition to interval cytoreductive surgery (CRS) received a strong positive recommendation that merits inclusion in routine care. Single-agent cisplatin was the only drug recommended for routine care, and OVHIPEC-1 was the most preferred regimen. The panel recommended performing HIPEC for a minimum of 60 min with a recommended minimum intraabdominal temperature of 41°C. Nephroprotection with sodium thiosulfate should be used for cisplatin HIPEC.The results of this consensus should guide clinical decisions on indications of HIPEC and the choice and various parameters of HIPEC regimens and could fill current knowledge gaps. These outcomes should be the basis for designing future clinical trials on HIPEC in EOC.© 2023. Society of Surgical Oncology.