Gastroesophageal Pathology Departement, N.N. Alexandrov National Cancer Center, Minsk, Belarus.
United Institute of Informatics Problems, National Academy of Sciences, Minsk, Belarus.
Eur J Surg Oncol. 2019 Dec;45(12):2405-2411. doi: 10.1016/j.ejso.2019.07.030. Epub 2019 Jul 31.
Evaluation of hyperthermic intraperitoneal chemotherapy (HIPEC) in reducing metachronous peritoneal metastases (MPM) risks in patients with resectable serosa-invasive gastric cancer.
MATERIALS & METHODS: Between 2008 and 2016, 154 patients with gastric cancer (stage IIB-IIIC) were randomly assigned to two groups: 76 patients underwent HIPEC (cisplatin 50 mg/m + doxorubicin 50 mg/m, 42 °C, 1 h) combined with radical surgery (HIPEC group) and 78 patients underwent only radical surgery (control group).
Evaluation of HIPEC toxicity showed neither toxic complications of IV-V degree nor haematological toxicity (according to CTCAE v. 4.03). There was no significant difference in the rate of complications between the two groups (p = 0.254). There was a more frequent disease progression in the control group than in the HIPEC group: 42/55 patients (76.4%) vs. 36/68 patients (52.9%), respectively (p = 0.009). At the same time a significant decrease in the rate of MPM was observed after HIPEC administration as compared with surgery alone - 16/68 (12.8%) vs. 39/55 (27.6%) (p < 0.001). 3-year progression-free survival was 47% (95% CI 36-61)) in the HIPEC group and 27% (95% CI 17-43) in the control group - p = 0.0024. The N-stage, HIPEC procedure, type of surgery and interaction between HIPEC treatment and age were independent prognostic factors.
HIPEC appears to be helpful in improving treatment results in radically operated gastric cancer patients.
评估腹腔内热化疗（HIPEC）在降低可切除浆膜浸润性胃癌患者的异时性腹膜转移（MPM）风险中的作用。
2008 年至 2016 年间，154 例胃癌（IIB-IIIC 期）患者被随机分为两组：76 例患者接受 HIPEC（顺铂 50mg/m 2 + 多柔比星 50mg/m 2 ，42°C，1 小时）联合根治性手术（HIPEC 组），78 例患者仅接受根治性手术（对照组）。
HIPEC 毒性评估显示，无 IV-V 度毒性并发症，也无血液学毒性（根据 CTCAE v. 4.03）。两组并发症发生率无显著差异（p=0.254）。对照组疾病进展较 HIPEC 组更为频繁：55 例患者中有 42 例（76.4%），68 例患者中有 36 例（52.9%）（p=0.009）。同时，与单独手术相比，HIPEC 给药后 MPM 的发生率显著降低，68 例患者中有 16 例（12.8%），55 例患者中有 39 例（27.6%）（p<0.001）。HIPEC 组 3 年无进展生存率为 47%（95%CI 36-61），对照组为 27%（95%CI 17-43）-p=0.0024。N 分期、HIPEC 手术、手术类型和 HIPEC 治疗与年龄之间的相互作用是独立的预后因素。
HIPEC 似乎有助于改善根治性手术治疗的胃癌患者的治疗效果。
