Role of Chemotherapy in Peritoneal Carcinomatosis in Metastatic Colorectal Cancer

摘要

Peritoneal carcinomatosis from colorectal cancer is increasingly recognized as a special form of metastatic disease. This review focuses on the efficacy of systemic chemotherapy in the setting of peritoneal carcinomatosis. Peritoneal carcinomatosis-affected individuals succumb to their disease earlier than those without known carcinomatosis, with an approximately 30 % reduction in overall survival. Modern cytotoxic combination chemotherapy incorporating oxaliplatin and irinotecan has resulted in marked improvement of overall survival among carcinomatosis patients, but not to the same extent as for non-carcinomatosis patients. Biologicals are also associated with increased overall survival, but still seem to underperform in the carcinomatosis patient. Efficacy of 5FU monotherapy seems negligible. Evidence suggests future trials should be stratified by peritoneal carcinomatosis status. Complementary benefits of systemic chemotherapy and cytoreductive surgical approaches warrant further studies.