Chemical treatment of peritoneal mesothelioma

By | April 23, 2012

The chemical treatment of peritoneal mesothelioma, 1, commonly used chemotherapy drugs: the PMM, is currently no standard chemotherapy drugs and chemotherapy regimens to cytotoxic chemotherapy drugs such as doxorubicin lead and shun the card application lead over shirt, Meanwhile mitomycin, bleomycin ,5-Fu, also have some therapeutic value.
Soon Lead (Cisplatin, DDP): each adult 80 / when-120mg / time, every 3 weeks for a course of treatment, intravenous injection; or 20mg/m2, for 5 days every 3 weeks as a course of intravenous injection. The main side effects of renal toxicity, gastrointestinal reactions. Cis amount of lead is greater than 50mg at a time, before and after treatment should be hydration and mannitol, and furosemide, a diuretic to reduce its accumulation in the tubular cells. For severe gastrointestinal reactions, 5-HT3 inhibitors (such as ondansetron, ondansetron) and Dexamethasone in patients with gastrointestinal reactions to greatly reduced. ) Intraperitoneal injection of lead in the top of the application of specific methods, see below.
Card lead CCarboplatin, CBP): each adult 300 – 400mg /, adding 5% glucose solution or saline, diluting the concentration of 0.5mg/ml solution, intravenous infusion, every 3 – 4 weeks duplication; or lOOmg / d, add 500ml of 5% glucose solution intravenously for 5 days; 3 – 4 weeks duplication. Also be used for each 300 – 500mg intraperitoneal injection once a week 1. Card lead nephrotoxicity, gastrointestinal tract was significantly smaller than the DDP, but in severe bone marrow suppression.
Adriamycin CAdriamycin, ADM): for each adult 30 – 60mg / when 1 every 3 weeks, intravenous or intraperitoneal injection of a total dose of no more than 550mg/m20 adverse reaction to a cardiac toxicity, and there is accumulation, and the total dose, followed by bone marrow suppression, gastrointestinal reactions and hair loss.
Peritoneal Mesothelioma Chemotherapy 2, chemotherapy:
Systemic chemotherapy: chemotherapy of peritoneal mesothelioma is undoubtedly the most convenient way to clinical application, but the drawback is that for the PMM local tumor characteristics gathered in the abdominal cavity, abdominal cavity after administration of drug distribution less. Commonly used chemotherapy regimens include: DDP + ADM, CBP + ADM and so on. But many scholars stressed that chemotherapy does not improve the outcome. I believe that for different patients, combined with chemotherapy should be based on the compatibility of specific chemotherapy in patients with drug toxicity and tolerance of circumstances.
Intraperitoneal chemotherapy: In recent years we gradually realize that, for the PMM by intraperitoneal injection of chemotherapy drugs may improve the local drug concentration and reduce systemic adverse reactions; not only for patients after eradication of residual tumor tissue, reduce relapse, but also to some mass loss of the surgical patients reduced, ascites, the condition under control. Intraperitoneal and intravenous dose of a similar amount, or slightly higher than the latter, repeated after 1 week. Under the condition of continuous injection of a few weeks.
CHPP C continuous hyperthermic peritoneal perfusion, continuous intraperitoneal infusion heating, also known as IPHP), which sustained intraperitoneal heated chemotherapy, the tumor region by the double heat treatment and chemotherapy drugs, so that the better the effect of chemotherapy. PIrk other studies reported in the 1993-1998 application for the drug along the base of the CHPP uranium for the 18 cases of mesothelioma (17 cases PMM, l cases of symptomatic recurrent cystic mesothelioma) cytoreductive surgery for patients treatment of 90 minutes. CHPP parameters included: the implementation of cisplatin the median amount of 530mg (range: 187-816mg), perfusion 6.0L (range :4-9L), flow rate I.SL / min (range: 1-2L/min), intra-abdominal temperature 41 C (range: 38. C-43.2 C). Follow-up data show that after CHPP treatment, no one case of operative death, the median survival was 26 months, 2-year survival of 80% of patients; surgical complications was 24%, including 2 cases of superficial wound infection and 1 case with There are many elderly patients with diseases of the intestinal infection called control; treatment mainly for the application of toxic lead in excess of the prescribed dose of cis after renal toxicity; 10 cases occurred after cytoreductive surgery in patients with ascites subsided after treatment of 9 cases; 3 cases of recurrence after treatment of ascites in patients (1, respectively, after treatment in the 27,22 and 10 months) after treatment of ascites subsided again, response to treatment and 4, respectively 24,6 months. Of course, in the evaluation of treatment should pay attention to the study was done in combination with cytoreductive surgery, but undeniable, CHPP with malignant peritoneal mesothelioma treatment of malignant ascites and even a new way to fly for extended patient survival time and improve the quality of life of patients provides a new approach.
Peritoneal mesothelioma chemotherapy, 3, the progress of peritoneal mesothelioma chemotherapy drugs: the design of chemotherapy regimens for the PMM to minimize the toxicity of chemotherapy and for the purpose of increasing drug activity, along with advances in pharmacology and medicinal chemistry, In recent years, several more have begun to hope that the chemotherapy drugs and clinical trial application or in the pilot phase of Chen.

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