Review for 10.1186/s12876-022-02109-z (2022)

Reviewer’s report
Title: 
Lobaplatin hyperthermic intraperitoneal chemotherapy plus cytoreduction
and rechallenge using cetuximab for wild-type RAS peritoneal metastatic colon
cancer: a case report and literature review
Version: 
1 
Date: 
20 Dec 2021
Reviewer's report:
A 49-year-old man was diagnosed with sigmoid colon cancer. He had peritoneal
metastases, and underwent laparoscopic resection, biopsy of the metastatic
nodules, and intraperitoneal administration. He received HIPEC (20 mg
lobaplatin) for 5 consecutive days. He received cetuximab and XELOX, but had
no effect and changed to cetuximab and FOLFIRI. Tumor markers decreased,
but administration was discontinued due to myelosuppression. He relapsed four
months later and re-challenged cetuximab and FOLFIRI, but was unable to
continue due to myelosuppression. He underwent intraperitoneal thermal
perfusion of FOLFIRI, but developed intestinal obstruction. After HIPEC, total
colectomy, CRS, and HIPEC were performed. It is stable with FOLFIRI and
cetuximab and has survived for more than 45 months.
Authors should analyze whether a nodular shadow in the anterior segment of
the upper lobe of the right lung is lung metastasis.
The reason for not creating fistula is to avoid recurrence, but it seems that
excision is easy even if it recurs in the fistula part.
You should analyze whether the risk of recurrence increases, if complications
like anastomotic leakage may occur after CRS and you cannot use chemotherapy
for a while.
How was the effect judgment of HIPEC after the operation?
There is a distal intestinal wall of sigmoid colon, but what happens to the
resection of the sigmoid colon in the first surgery?
You could predict myelosuppression after FOLFIRI + cetuximab re-challenge,
but why didn't I change the drug?
Why didn't lobaplatin enter the intra-abdominal heat perfusion in combination
with adjuvant?
Is the reason for the intestinal obstruction a recurrence of the anastomotic site?
Why did you have a total colorectal resection instead of an anastomotic
resection?
You have used FOLFIRI + cetuximab in chemotherapy after two surgeries.
You should analyze if myelosuppression occurs.
If lobaplatin has a high risk of anastomotic insufficiency, I think that the
timing of administration is inappropriate.
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