One vs Three HIPEC Cycles After CRS for Pseudomyxoma Peritonei

Inclusion criteria

• Voluntarily consent to participate, sign informed consent, and be willing and able to comply with the study protocol;
• Age 18-70 years;
• Undergo CRS+HIPEC with pathological diagnosis of PMP of high grade with signet-ring cells, high grade, or low grade;
• Karnofsky performance status (KPS) >60;
• Adequate function of major organs as follows:

• Hematology: WBC ≥3.5×10^9/L, ANC ≥1.0×10^9/L, LC ≥0.5×10^9/L, PLT ≥80×10^9/L, Hb ≥90 g/L;
• Hepatic function: AST, ALT, and TBIL ≤2×upper limit of normal (ULN);
• Renal function: serum creatinine <1.2×ULN;
• Coagulation: APTT ≤1.5×ULN; INR or PT ≤1.5×ULN;
• Cardiopulmonary function sufficient to tolerate major surgery and HIPEC;

(5) Radiological Peritoneal Cancer Index (PCI) ≥15; (6) No local or systemic antitumor therapy within 1 month prior to CRS+HIPEC; (7) Adverse reactions from prior treatments have resolved before study initiation or, in the investigator's judgment, will not interfere with this study;

Exclusion criteria

• Metastases to lung, brain, bone, or liver;
• AST, ALT, or TBIL ≥2×ULN;
• Serum creatinine ≥1.2×ULN;
• Severe mesenteric contraction;
• Major organ dysfunction that cannot support the planned procedures;
• Concomitant hematological disorders or other malignancies;
• Acute or subacute infectious disease;
• History of allergy to cisplatin or docetaxel, or marked allergic diathesis or severe allergy history;
• Psychiatric or psychological disorders preventing cooperation with treatment and efficacy evaluation;
• Any other condition deemed unsuitable for enrollment by the investigator;