Aigner Kornelia, Vashist Yogesh Kumar, Selak Emir, Gailhofer Sabine, Aigner Karl Reinhard
Clinic for Surgical Oncology, Medias Klinikum Burghausen, 84489 Burghausen, Germany.
J Clin Med. 2021 Nov 15;10(22):5322. doi: 10.3390/jcm10225322.
Peritoneal spread is frequent in gastric cancer (GC) and a palliative condition. After failure to systemic chemotherapy (sCTx) remaining therapeutic options are very limited. We evaluated the feasibility and efficacy of locoregional chemotherapy (RegCTx) in peritoneal metastatic GC. In total, 38 (23 male and 15 female) patients with peritoneal metastatic GC after failure of previous sCTx and unresectable disease were enrolled in this study. Using the hypoxic abdominal stop-flow perfusion, upper abdominal perfusion and intraarterial infusion technique in total 114 cycles with Cisplatin, Adriamycin and Mitomycin C were applied. No significant procedure related toxicity was noticed- especially no Grade 3 or 4 toxicity occurred. With the RegCTx approach a median overall survival of 17.4 months was achieved. Patients who had undergone previously resection of the GC the median overall survival was even better with 23.5 months. RegCTx is a promising, safe and efficient approach in diffuse metastatic GC. The evaluation of RegCTx in the setting of multimodal treatment approach at less advanced stages is also warranted.
腹膜播散在胃癌（GC）中很常见，是一种姑息性情况。在全身化疗（sCTx）失败后，剩余的治疗选择非常有限。我们评估了局部区域化疗（RegCTx）在腹膜转移性GC中的可行性和疗效。本研究共纳入38例（23例男性和15例女性）先前sCTx失败且疾病无法切除的腹膜转移性GC患者。使用缺氧性腹部停流灌注、上腹部灌注和动脉内灌注技术，共应用了114个周期的顺铂、阿霉素和丝裂霉素C。未发现与手术相关的显著毒性——尤其是未发生3级或4级毒性。采用RegCTx方法，中位总生存期达到17.4个月。先前接受过GC切除术的患者中位总生存期甚至更好，为23.5个月。RegCTx在弥漫性转移性GC中是一种有前景、安全且有效的方法。在病情不太严重的阶段，对RegCTx在多模式治疗方法中的评估也很有必要。
