Cui Hai-Bin, Ge Huai-E, Bai Xi-Yong, Zhang Wei, Zhang Yuan-Yuan, Wang Juan, Li Xing, Xing Lian-Ping, Guo Sheng-Hu, Wang Zhi-Yu
Department of Immunotherapy, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China ; Department of Oncology, Cangzhou Central Hospital, Cangzhou, Hebei 061001, P.R. China.
Department of Oncology, Cangzhou Central Hospital, Cangzhou, Hebei 061001, P.R. China.
Exp Ther Med. 2014 May;7(5):1083-1088. doi: 10.3892/etm.2014.1599. Epub 2014 Mar 4.
Neoadjuvant and hyperthermic intraperitoneal chemotherapies have been shown to be effective in the treatment of resectable advanced gastric cancer. The aim of the present study was to investigate the clinical efficiency and security of neoadjuvant chemotherapy in combination with hyperthermic intraperitoneal chemotherapy for the treatment of postoperative advanced gastric cancer. A total of 192 patients diagnosed with advanced gastric cancer were randomly divided into the following four groups (n=48 per group): Control, neoadjuvant chemotherapy, hyperthermic intraperitoneal perfusion chemotherapy and joint groups. The joint group received neoadjuvant chemotherapy combined with hyperthermic intraperitoneal perfusion chemotherapy. Complications, adverse reactions, recurrence rates within 2 years and the 1- and 3-year survival rates following surgery were observed. No significant differences were observed in the occurrence rates of I-II degree myelosuppression, III-IV degree myelosuppression, I-II degree nausea or III-IV degree nausea and vomiting among the four groups (P>0.05). The median progression-free survival times were 26, 31, 33 and 28 months in the control, neoadjuvant chemotherapy, hyperthermic intraperitoneal perfusion chemotherapy and joint groups, respectively (P<0.001). Compared with the control group, the recurrence-free 2-year survival rate of the joint group was significantly lower (P=0.04). The difference among the median survival times of the four groups was statistically significant (P=0.001). The 1-year survival rate of the joint group was significantly higher when compared with the control group and the difference was statistically significant (P=0.03). However, no statistically significant difference was identified among the 1-year survival rates of the four groups (P>0.05). Compared with the control group, the 3-year survival rates of the other three groups were significantly higher (P<0.05). Therefore, the results of the present study indicated that neoadjuvant chemotherapy combined with hyperthermic intraperitoneal perfusion chemotherapy for the treatment of advanced gastric cancer is well tolerated and exhibits improved compliance and efficiency.
新辅助化疗和腹腔热灌注化疗已被证明在可切除的进展期胃癌治疗中有效。本研究的目的是探讨新辅助化疗联合腹腔热灌注化疗治疗术后进展期胃癌的临床疗效和安全性。总共192例被诊断为进展期胃癌的患者被随机分为以下四组（每组n = 48）：对照组、新辅助化疗组、腹腔热灌注化疗组和联合组。联合组接受新辅助化疗联合腹腔热灌注化疗。观察术后并发症、不良反应、2年内复发率以及1年和3年生存率。四组之间在I-II度骨髓抑制、III-IV度骨髓抑制、I-II度恶心或III-IV度恶心呕吐的发生率方面未观察到显著差异（P>0.05）。对照组、新辅助化疗组、腹腔热灌注化疗组和联合组的中位无进展生存时间分别为26、31、33和28个月（P<0.001）。与对照组相比，联合组的2年无复发生存率显著降低（P = 0.04）。四组中位生存时间的差异具有统计学意义（P = 0.001）。联合组的1年生存率与对照组相比显著更高，差异具有统计学意义（P = 0.03）。然而，四组的1年生存率之间未发现统计学显著差异（P>0.05）。与对照组相比，其他三组的3年生存率显著更高（P<0.05）。因此，本研究结果表明，新辅助化疗联合腹腔热灌注化疗治疗进展期胃癌耐受性良好，且依从性和疗效有所提高。
