Effect of transarterial chemotherapy on the outcome and prognosis of patients with locally advanced proximal gastric cancer.

OBJECTIVE

To investigate the effect of transarterial infusion chemotherapy on the prognosis of patients undergoing proximal radical gastrectomy for gastric cancer.

METHODS

In this retrospective study, 96 patients with locally advanced proximal gastric cancer diagnosed in Gansu Cancer Hospital from July 2014 to July 2017 were enrolled. Among them, 40 patients undergoing surgery after 4 cycles of intravenous + oral chemotherapy and 2-4 cycles of adjuvant chemotherapy after surgery were grouped as the control group (CG); the remaining 56 patients treated with left gastric artery infusion chemotherapy were grouped as the observation group (OG). The clinical efficacy, surgical regimen, adverse reactions (nausea, vomiting, and bone marrow suppression) after chemotherapy, improvement of clinical symptoms, 5-year survival, 5-year progression-free survival (PFS) and overall response rate (ORR) after treatment were compared between the two groups. Cox regression was used to analyze prognostic factors affecting PFS.

RESULTS

Compared to the CG, the OG exhibited a significantly higher overall response rate and smaller tumor volume (P < 0.05 or P < 0.01); the overall incidence of clinical symptoms in the OG was lower (P < 0.05); the proportion of patients who underwent radical resection in the OG was significantly higher (P < 0.05); nausea and vomiting symptoms were more common in the OG (P < 0.05), but there was no statistical difference in terms of bone marrow suppression (P > 0.05); and the OG had significantly higher 5-year progression-free survival and survival time of patients (P < 0.05). Cox regression analysis revealed that tumor stage, tumor type and treatment regimen were independent prognostic factors for PFS (P < 0.01).

CONCLUSION

Regional arterial infusion chemotherapy is an ideal neoadjuvant therapy for gastric cancer, which can evidently reduce the tumor lesions in a short time, increase the resection rate, and significantly prolong the PFS of the patients. The gastrointestinal side effects are comparatively significant but tolerable.