Yuan Meiqin, Wang Zeng, Hu Guinv, Yang Yunshan, Lv Wangxia, Lu Fangxiao, Zhong Haijun
Department of Chemotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China.
Department of Pharmacy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China.
Mol Clin Oncol. 2016 Aug;5(2):395-399. doi: 10.3892/mco.2016.918. Epub 2016 Jun 2.
Peritoneal metastasis (PM) is a poor prognostic factor in patients with gastric cancer. The aim of this study was to evaluate the efficacy and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced gastric cancer with PM by retrospective analysis. A total of 54 gastric cancer patients with positive ascitic fluid cytology were included in this study: 23 patients were treated with systemic chemotherapy combined with HIPEC (HIPEC+ group) and 31 received systemic chemotherapy alone (HIPEC- group). The patients were divided into 4 categories according to the changes of ascites, namely disappear, decrease, stable and increase. The disappear + decrease rate in the HIPEC+ group was 82.60%, which was statistically significantly superior to that of the HIPEC- group (54.80%). The disappear + decrease + stable rate was 95.70% in the HIPEC+ group and 74.20% in the HIPEC- group, but the difference was not statistically significant. In 33 patients with complete survival data, including 12 from the HIPEC+ and 21 from the HIPEC- group, the median progression-free survival was 164 and 129 days, respectively, and the median overall survival (OS) was 494 and 223 days, respectively. In patients with ascites disappear/decrease/stable, the OS appeared to be better compared with that in patients with ascites increase, but the difference was not statistically significant. Further analysis revealed that patients with controlled disease (complete response + partial response + stable disease) may have a better OS compared with patients with progressive disease, with a statistically significant difference. The toxicities were well tolerated in both groups. Therefore, HIPEC was found to improve survival in advanced gastric cancer patients with PM, but the difference was not statistically significant, which may be attributed to the small number of cases. Further studies with larger samples are required to confirm our data.
腹膜转移（PM）是胃癌患者预后不良的因素。本研究旨在通过回顾性分析评估热灌注腹腔化疗（HIPEC）对晚期胃癌伴PM患者的疗效和安全性。本研究共纳入54例腹水细胞学检查阳性的胃癌患者：23例患者接受全身化疗联合HIPEC（HIPEC+组），31例仅接受全身化疗（HIPEC-组）。根据腹水变化将患者分为4类，即消失、减少、稳定和增加。HIPEC+组的消失+减少率为82.60%，统计学上显著优于HIPEC-组（54.80%）。HIPEC+组的消失+减少+稳定率为95.70%，HIPEC-组为74.20%，但差异无统计学意义。在33例有完整生存数据的患者中，包括HIPEC+组的12例和HIPEC-组的21例，无进展生存期的中位数分别为164天和129天，总生存期（OS）的中位数分别为494天和223天。腹水消失/减少/稳定的患者，其OS似乎比腹水增加的患者更好，但差异无统计学意义。进一步分析显示，疾病得到控制（完全缓解+部分缓解+病情稳定）的患者与疾病进展的患者相比，OS可能更好，差异有统计学意义。两组对毒性的耐受性均良好。因此，发现HIPEC可改善晚期胃癌伴PM患者的生存期，但差异无统计学意义，这可能归因于病例数较少。需要更大样本的进一步研究来证实我们的数据。
