Cytoreductive Surgery Under Aminolevulinic Acid-Mediated Photodynamic Diagnosis Plus Hyperthermic Intraperitoneal Chemotherapy in Patients with Peritoneal Carcinomatosis from Ovarian Cancer and Primary Peritoneal Carcinoma: Results of a Phase I Trial
| Autor: | Haruaki Ishibashi, Yutaka Yonemura, Takuji Fujita, Yoshio Endo, Toshihiro Nishioka, Shun-ichiro Ogura, Yang Liu, Yan Li, Emel Canbay |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Phases of clinical research Gastroenterology Primary peritoneal carcinoma Surgical oncology Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Carcinoma Humans Peritoneal Neoplasms Aged Neoplasm Staging Ovarian Neoplasms Chemotherapy Photosensitizing Agents business.industry Cancer Aminolevulinic Acid Cytoreduction Surgical Procedures Hyperthermia Induced Gynecologic Oncology Middle Aged medicine.disease Prognosis Combined Modality Therapy Carcinoma Papillary Surgery Cystadenocarcinoma Serous Survival Rate Oncology Chemotherapy Adjuvant Chemotherapy Cancer Regional Perfusion Feasibility Studies Hyperthermic intraperitoneal chemotherapy Female Ovarian cancer business Injections Intraperitoneal Follow-Up Studies |
| Zdroj: | Annals of Surgical Oncology |
| ISSN: | 1534-4681 1068-9265 |
| Popis: | Background We conducted a phase I clinical trial to evaluate the sensitivity, specificity, and safety of cytoreductive surgery (CRS) under aminolevulinic acid-mediated photodynamic diagnosis (ALA-PDD) plus hyperthermic intraperitoneal chemotherapy (HIPEC) on 20 patients with peritoneal carcinomatosis (PC) from ovarian cancer and primary peritoneal carcinoma (PPC). Patients and Methods Patients took 5-aminolevulinic acid (5-ALA) at a dose of 20 mg/kg orally with 50 mL of water 2 h before surgery. During surgery, the abdominal cavity was observed under blue light (wavelength of 440 nm) before and after CRS plus HIPEC. Specimens were excised and submitted for pathological examination to evaluate the specificity of ALA-PDD. Postoperative course was closely monitored and detailed information was recorded. Results CRS under ALA-PDD plus HIPEC was performed 21 times in 20 patients with PC (16 ovarian cancer, 4 PPC) between June 2011 and October 2013. With the exception of 1 (5 %) patient, strong red fluorescence was detected in 19 patients with ovarian cancer, with a sensitivity of 95 %. All specimens from red fluorescent lesions were invaded by cancer cells, with a specificity of 100 %. No severe adverse events occurred during the perioperative period, with the exception of some abnormal laboratory results and mild complications. All patients were alive until the last follow-up. Conclusion ALA-PDD provided a high sensitivity and specificity in detecting peritoneal metastasis in patients with PC from ovarian serous carcinoma and PPC. CRS under ALA-PDD plus HIPEC was a feasible and safe treatment option for patients with PC from ovarian cancer and PPC. |
| Databáze: | OpenAIRE |
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