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 臨 床 案 例 
Clinical Cases
腹腔熱化療可以應用在許多不同的病況,無法一一舉例。在這裡我們僅舉出三個典型案例以供參考。其中更顯現出在複雜案例中以多團隊合作治療的重要性。
以下所列舉的例子,目前都健在且無法發跡象。

第一例為闌尾黏液癌。個案於2008年在其他醫院接受腸阻塞手術,術中發現腹腔內大量黏液而未發現其他腫瘤。之後於萬芳醫院接受闌尾癌切除手術,腹膜剝離術,腫瘤減量手術及腹腔熱化療,術後一度復發但手術困難度高,安排給予電腦刀放射線治療。目前情況良好都無復發,並仍工作中。






第二例為腹膜間皮瘤。個案於2008年底因大量腹水於其他醫院接受腹腔鏡檢查及切片,證實為瀰漫性惡性間皮瘤。因範圍廣泛不建議手術,只給全身性化學治療。其後病患至萬芳醫院,於2009年初接受腫瘤減量手術,腹膜剝離術以及腹腔熱化療,以及後續全身性化療。其後經過兩次復發並接受兩次腫瘤減量手術以及腹腔熱化療。至今皆無復發並恢復日常全職工作中。








第三例為胃癌併腹腔內卵巢轉移案例。個案於2009年經胃鏡及電腦斷層掃描,診斷為胃腺癌合併腹腔卵巢轉移。我們實施了根除性胃次全切除術,腹膜剝離術以及子宮卵巢切除,同時給予腹腔熱化療。術後並接受六個月全身性化療。截至目前為止都無復發跡象,並定時回診。





第四例為大腸癌病例。個案於2011年於其他醫院接受大腸癌手術,為第三期。術後並追加輔助性全身化學治療。於2014年12月發現有腹腔內復發現象,於是再追加化學治療及標靶治療12次,但效果不佳,故又追加6次。但病情仍未改善,於2015年,故又接續其他標靶治療。但由於副作用而未能完成所有治療。然而由於病況持續惡化,並轉移到肺。個案來到萬芳醫院,經評估後於2016年六月實施全腹膜剝離手術及腫瘤減量手術,肺轉移切除並給予腹腔熱化療。術後情況良好。







仍然有很多其他例子,包含大腸直腸癌,卵巢癌,子宮內膜癌......。 歡迎諮詢!!
HIPEC can be applied in many disease conditions. It is impossible to show all cases. Here, we present 3 typical cases for reference. Among them, we can see the importance of multidisciplinary treatment.

Case 1: A case of appendiceal mucinous adenocarcinoma. He received an operation for intestinal obstruction at other hospital. Only large amount of mucinous material was found without any tumor. Then he received the surgery for appendiceal cancer, peritonectomy and cytoreduction surgery with HIPEC on 2008. Local recurrence was found at follow up. Because surgical treatment was difficult, we arrange Cyberknife radiotherapy for him. At the present, he is still well without disease recurrence and returned to his regular work.

Case 2: A case of malignant mesothelioma. He experienced large amount of ascites and received laparoscopy with biopsy at other hospital, at December 2008. It was proved as a diffuse malignant peritoneal mesothelioma. Due to diffuse peritoneal seeding, only systemic chemotherapy instead of surgery was advised. The he came to Wan-Fang Hospital for further management. We performed peritonectomy, cytoreduction surgery with HIPEC at Jan 2009, with adjuvant systemic chemotherapy. Then he experienced two time of recurrence and also received two times of cytoreduction surgery with HIPEC. Till now, there is no evidence of recurrence and he already returned to his full time work.

Case 3: A case of adenocarcinoma of the stomach. Gastroscopy and CT scan were done before surgery, with the diagnosis of gastric adenocarcinoma with peritoneal & ovary metastasis. We performed radical subtotal gastrectomy, peritonectomy, hysterectomy with oophorectomy, with HIPEC. Post-operative adjuvant systemic chemotherapy was given for 6 months. Till now, there is n evidence of recurrence and she still return to Out Patient Department as scheduled.

Case 4: A recurrent colon cancer. This patient received colon cancer surgery at 2011 at other hospital with pathological stage IIIa, and adjuvant chemotherapy. Intraperitoneal recurrence was noted at 2014 December, then systemic chemotherapy with target therapy for 12 cycles, but the result was poor, so another 6 cycles were added. However, the disease progressed then another target therapy was given at 2015. However, the treatment was not completed due to side effects of target therapy, and the cancer metastasized to lung. Later, the patient consulted us. After detailed evaluation at Wan-Fang Hospital, we performed total parietal peritonectomy, cytoreduction surgery, resection of the lung lesion and HIPEC. The post-operative condition was very well.

There are still many cases, including colon/rectal cancers, ovarian cancer, endometrial cancers. Welcome for consultation !!

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