Abstract：
Peritoneal metastatic cancer is a cancer caused by the direct growth of cancer cells from the primary site through the bloodstream, lymph, or peritoneum, which is a difficult part of current clinical treatment. In the abdominal cavity of patients with metastatic peritoneal cancer, there are usually nodules of various sizes and malignant ascites. Among them, nodules of different sizes can obstruct intestinal movement and form intestinal obstruction, while malignant ascites can cause abdominal distension and discomfort, and even cause patients to have difficulty in breathing. The pathology and physiology of peritoneal metastatic cancer are complex and not fully understood. The main hypothesis is \"seed\" and \"soil\"; i.e., cells from the primary tumor are shed and implanted in the peritoneal cavity (peritoneal metastasis). In the last two decades, the main treatment modalities used clinically are cytoreductive surgery (CRS), systemic chemotherapy, intraperitoneal chemotherapy, and combined treatment, all of which help to improve patient survival and quality of life (QOL). However, the small-molecule chemotherapeutic drugs used clinically still have problems such as rapid drug metabolism and systemic toxicity. With the rapid development of nanotechnology in recent years, therapeutic nanoagents for the treatment of peritoneal metastatic cancer have been gradually developed, which has improved the therapeutic effect and reduced the systemic toxicity of small-molecule chemotherapeutic drugs to a certain extent. In addition, nanomaterials have been developed not only as therapeutic agents but also as imaging agents to guide peritoneal tumor CRS. In this review, we describe the etiology and pathological features of peritoneal metastatic cancer, discuss in detail the clinical treatments that have been used for peritoneal metastatic cancer, and analyze the advantages and disadvantages of the different clinical treatments and the QOL of the treated patients, followed by a discussion focusing on the progress, obstacles, and challenges in the use of therapeutic nanoagents in peritoneal metastatic cancer. Finally, therapeutic nanoagents and therapeutic tools that may be used in the future for the treatment of peritoneal metastatic cancer are prospected.
摘要：
腹膜转移癌是由癌细胞从原发部位通过血流直接生长引起的癌症，淋巴，或者腹膜,这是当前临床治疗的难点。在转移性腹膜癌患者的腹腔中，通常有各种大小的结节和恶性腹水。其中,不同大小的结节可阻碍肠道运动，形成肠梗阻，而恶性腹水可引起腹胀和不适，甚至导致患者呼吸困难。腹膜转移癌的病理和生理学是复杂的，尚未完全了解。主要假设是“种子”和“土壤”；即，来自原发肿瘤的细胞脱落并植入腹膜腔（腹膜转移）。在过去的二十年里，临床上使用的主要治疗方式是细胞减灭术（CRS），全身化疗,腹腔化疗,联合治疗，所有这些都有助于提高患者的生存率和生活质量（QOL）。然而,临床使用的小分子化疗药物仍存在药物代谢快、全身毒性等问题。随着近年来纳米技术的迅速发展,用于治疗腹膜转移癌的治疗性纳米药物已逐渐发展，在一定程度上提高了治疗效果,降低了小分子化疗药物的全身毒性。此外,纳米材料不仅被开发作为治疗药物，而且作为显像剂引导腹膜肿瘤CRS。在这次审查中,我们描述了腹膜转移癌的病因和病理特征，详细讨论已用于腹膜转移癌的临床治疗方法，并分析不同临床治疗方法的优缺点及患者的生活质量,随后是围绕进展的讨论，障碍,以及在腹膜转移性癌症中使用治疗性纳米药物的挑战。最后,对未来可能用于腹膜转移癌治疗的纳米药物和治疗工具进行了展望。
