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Abstract：
BACKGROUND Malignant mesotheliomas are rare, yet highly malignant tumors. Mesotheliomas are tumors that develop from mesothelial surfaces, with the pleura being the most common, followed by the peritoneum. The diagnosis of malignant peritoneal mesothelioma (MPM) is usually established when the disease is advanced, owing to the nonspecific clinical appearance and abdominal symptoms. Initially, MPM was treated with palliative systemic chemotherapy, with or without palliative surgery. However, cytoreductive surgery (CRS) combined with bidirectional intraoperative chemotherapy (BDIC) has recently emerged as a treatment option for MPM. BDIC creates a bidirectional chemotherapy gradient in the peritoneal tumor cells through the simultaneous use of intraperitoneal and intravenous chemotherapy. CRS, combined with BDIC (CRS-BDIC), allows the complete elimination of residual tiny tumor cells after complete removal of the visible tumor nodules. CASE REPORT Herein, we present a case of a 51-year-old woman with MPM and chronic kidney disease (CKD) stage 3b. Her treatment consisted of neoadjuvant chemotherapy and immunotherapy, followed by CRS-BDIC using intraperitoneal cisplatin and doxorubicin, and intravenous ifosfamide. The surgery was successful, with no immediate complications or decline in the patient\'s kidney function. On follow up 2 months later, the patient denies suffering any chemotherapy-related adverse effects, and her kidney profile remains stable. CONCLUSIONS In conclusion, nephrotoxicity, a known adverse effect of cisplatin and ifosfamide, might not be a contraindication for the use of these potentially nephrotoxic drugs in CRS-BDIC in patients with renal impairment.
摘要：
背景技术恶性间皮瘤是罕见的,然而高度恶性肿瘤。间皮瘤是从间皮表面发展而来的肿瘤，胸膜是最常见的,接着是腹膜.恶性腹膜间皮瘤（MPM）的诊断通常在疾病晚期时确定。由于非特异性临床表现和腹部症状。最初，MPM采用姑息性全身化疗，有或没有姑息手术。然而,细胞减灭术（CRS）联合双向术中化疗（BDIC）最近已成为MPM的治疗选择。BDIC通过同时使用腹膜内和静脉内化疗在腹膜肿瘤细胞中产生双向化疗梯度。CRS,结合BDIC（CRS-BDIC），允许在完全去除可见的肿瘤结节后完全消除残留的微小肿瘤细胞。这里的案例报告，我们介绍一例51岁女性,患有MPM和慢性肾脏病(CKD)3b期.她的治疗包括新辅助化疗和免疫疗法，然后使用腹膜内顺铂和阿霉素进行CRS-BDIC，和静脉注射异环磷酰胺.手术很成功,没有立即并发症或患者肾功能下降。在2个月后的随访中，患者否认有任何化疗相关的不良反应，她的肾脏特征保持稳定.结论：肾毒性，顺铂和异环磷酰胺的已知不良反应，在肾功能损害患者的CRS-BDIC中使用这些潜在肾毒性药物可能不是禁忌症.
