Wu Zhibing, Ma Shenglin, Jing Saisai, Deng Qinghua, Zheng Zhishuang, Wu Kan, Li Juan, Chen Sumei, Tang Rongjun, Li Xiadong
Hepatogastroenterology. 2014 Jun;61(132):972-7.
BACKGROUND/AIMS: The aim is to evaluate the preliminary efficacy and side effects of paclitaxel, 5-fluorouracil, and leucovorin intravenous chemotherapy in combination with cisplatin hyperthermic intraperitoneal perfusion chemotherapy (HIPEC) as postoperative adjuvant therapy for patients of locally advanced gastric cancer (GC) at high risk for recurrence after curative resection.
Four GC patients who underwent radical gastrectomy with D2 lymphadenectomy were enrolled. All patients received paclitaxel 135 mg/m2 on day 1, 5-FU 500 mg/m2 on days 1-5, LV 200 mg/m2 on days 1-5 intravenous chemotherapy, cisplatin 75 mg/m2 on day 5, and HIPEC one month after surgery. It was repeated at 3 weeks intervals and at least two cycles administered.
A total of 181 cycles of chemotherapy were administered (median, 4 cycles). The median disease free survival time of patients was 40.8 months. The median overall survival time was 48.0 months. The one-, two-, and three-year recurrence rates were 14.6%, 26.8%, and 46.3%, respectively. The main relapse patterns were remnant GC and metastases of retroperitoneal lymph nodes. The morbidity of grade 3 and 4 toxicities of myelosuppression, nausea/ vomiting were less than 10%. The side effects of grade 1 and 2 of hematologic toxicity, nausea and vomiting, abnormal function of liver, kidney or cardiac, fatigue and neurotoxicity were well tolerated.
Cisplatin HIPEC combined with paclitaxel, 5-fluorouracil, and leucovorin intravenous chemotherapy regimen could improve the survival rate and decrease the postoperative recurrence of locally advanced GC.
背景/目的：目的是评估紫杉醇、5-氟尿嘧啶和亚叶酸钙静脉化疗联合顺铂热腹腔内灌注化疗（HIPEC）作为局部进展期胃癌（GC）根治性切除术后复发高危患者术后辅助治疗的初步疗效和副作用。
纳入4例接受D2淋巴结清扫根治性胃切除术的GC患者。所有患者在第1天接受紫杉醇135mg/m²，在第1 - 5天接受5-氟尿嘧啶500mg/m²，在第1 - 5天接受亚叶酸钙200mg/m²静脉化疗，在第5天接受顺铂75mg/m²，并在术后1个月接受HIPEC。每3周重复一次，至少进行两个周期。
共进行了181个周期的化疗（中位数为4个周期）。患者的无病生存期中位数为40.8个月。总生存期中位数为48.0个月。1年、2年和3年复发率分别为14.6%、26.8%和46.3%。主要复发模式为残留GC和腹膜后淋巴结转移。3级和4级骨髓抑制、恶心/呕吐的发生率低于10%。1级和2级血液学毒性、恶心和呕吐、肝、肾或心脏功能异常、疲劳和神经毒性的副作用耐受性良好。
顺铂HIPEC联合紫杉醇、5-氟尿嘧啶和亚叶酸钙静脉化疗方案可提高局部进展期GC的生存率并降低术后复发率。
