高温腹腔化学药物灌注疗法（HIPEC）与顺铂在上皮性卵巢癌（EOC）中具有生存优势，但与肾毒性有关。硫代硫酸钠（ST）用于HIPEC与顺铂的肾保护，但标准的HIPEC做法存在差异。一项前瞻性、非随机的临床试验评估了应用顺铂75mg/m2进行细胞减灭手术（CRS）期间HIPEC的安全性结果，研究对象包括EOC患者（n = 34）和子宫内膜癌患者（n = 6）。其中21名患者未接受ST（nST），19名患者接受了ST。根据CTCAE v.5.0报告了不良事件（AEs）。术前和术后（第5-8天）收集血清肌酸酐（Cr）水平，观察无进展生存期（PFS）。在进行HIPEC期间，对正常腹膜进行了活体组织检查，以进行RNA测序，以寻找与AEs相关的RNAseq标志。共有40名患者在间隔或继发CRS期间接受了HIPEC。在nST组中，肾毒性的任意级AE发生率为33%，3级AE发生率为9%。而ST组未发生肾AE。nST组术后Cr的中位数为1.1mg/dL，而ST组为0.5mg/dL（p = 0.0001）。nST组术前到术后Cr的中位数变化为+53%，ST组为-9.6%（p = 0.003）。在原发或复发EOC患者中，ST组和nST组的PFS无差异。肾AE与代谢途径下调和免疫途径上调有关。ST显著降低了与顺铂在卵巢癌患者中HIPEC相关的急性肾毒性。由于HIPEC与顺铂的肾毒性较高，应考虑使用肾保护剂。© 2023. 作者（们）。

Hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin confers a survival benefit in epithelial ovarian cancer (EOC) but is associated with renal toxicity. Sodium thiosulfate (ST) is used for nephroprotection for HIPEC with cisplatin, but standard HIPEC practices vary.A prospective, nonrandomized, clinical trial evaluated safety outcomes of HIPEC with cisplatin 75 mg/m2 during cytoreductive surgery (CRS) in patients with EOC (n = 34) and endometrial cancer (n = 6). Twenty-one patients received no ST (nST), and 19 received ST. Adverse events (AEs) were reported according to CTCAE v.5.0. Serum creatinine (Cr) was collected preoperatively and postoperatively (Days 5-8). Progression-free survival (PFS) was followed. Normal peritoneum was biopsied before and after HIPEC for whole transcriptomic sequencing to identify RNAseq signatures correlating with AEs.Forty patients had HIPEC at the time of interval or secondary CRS. Renal toxicities in the nST group were 33% any grade AE and 9% grade 3 AEs. The ST group demonstrated no renal AEs. Median postoperative Cr in the nST group was 1.1 mg/dL and 0.5 mg/dL in the ST group (p = 0.0001). Median change in Cr from preoperative to postoperative levels were + 53% (nST) compared with - 9.6% (ST) (p = 0.003). PFS did not differ between the ST and nST groups in primary or recurrent EOC patients. Renal AEs were associated with downregulation of metabolic pathways and upregulation of immune pathways.ST significantly reduces acute renal toxicity associated with HIPEC with cisplatin in ovarian cancer patients. As nephrotoxicity is high in HIPEC with cisplatin, nephroprotective agents should be considered.© 2023. The Author(s).