Department of Gastrointestinal surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Thoracic Surgery, Yubei District people's Hospital of Chongqing, Chongqing, China.
BMC Cancer. 2023 Mar 14;23(1):246. doi: 10.1186/s12885-023-10712-w.
The purpose of this study was to explore the short-term efficacy and safety of neoadjuvant chemotherapy combined with arterial chemoembolization for locally advanced gastric cancer (LAGC).
We retrospectively analyzed the clinical data of 203 patients with LAGC who received neoadjuvant therapy from June 2019 to December 2021. The patients were divided into a neoadjuvant chemotherapy combined with arterial chemoembolization group (combined group, n = 102) and a neoadjuvant chemotherapy group (conventional group, n = 101). The adverse events of chemotherapy, postoperative complications and pathological complete response (pCR) rate were compared between the two groups. Univariate and multivariate analyses were performed to evaluate the potential factors affecting pCR.
A total of 78.8% of the patients were in clinical stage III before neoadjuvant therapy. A total of 52.2% of the patients underwent surgery after receiving two cycles of neoadjuvant therapy. There were 21.2% patients with ≥ grade 3 (CTCAE 4.0) adverse events of chemotherapy and 11.3% patients with Clavien-Dindo classification ≥ grade 3 postoperative complications. Compared with the conventional group, the combination group did not experience an increase in the adverse events of chemotherapy or postoperative complications. The pCR rate in the combined group was significantly higher than that in the conventional group (16.7% vs. 4.95%, P = 0.012). The multivariate analysis showed that arterial chemoembolization, pre-treatment neutrophil-to-lymphocyte ratio (NLR) and pre-treatment platelet-to-lymphocyte ratio (PLR) were independent factors affecting pCR.
Neoadjuvant chemotherapy combined with arterial chemoembolization contributed to improving the pCR rate of LAGC patients. Arterial chemoembolization, pre-treatment NLR and pre-treatment PLR were also predictors of pCR.
本研究旨在探讨新辅助化疗联合动脉化疗栓塞治疗局部进展期胃癌（LAGC）的短期疗效和安全性。
我们回顾性分析了 203 例 2019 年 6 月至 2021 年 12 月接受新辅助治疗的 LAGC 患者的临床资料。患者分为新辅助化疗联合动脉化疗栓塞组（联合组，n=102）和新辅助化疗组（常规组，n=101）。比较两组患者化疗不良反应、术后并发症及病理完全缓解（pCR）率。采用单因素和多因素分析评估影响 pCR 的潜在因素。
新辅助治疗前，78.8%的患者处于临床 III 期。共有 52.2%的患者在接受两周期新辅助治疗后接受手术。化疗不良反应≥3 级（CTCAE 4.0）的患者占 21.2%，Clavien-Dindo 分级≥3 级的术后并发症患者占 11.3%。与常规组相比，联合组化疗不良反应和术后并发症发生率并未增加。联合组的 pCR 率明显高于常规组（16.7%比 4.95%，P=0.012）。多因素分析显示，动脉化疗栓塞、治疗前中性粒细胞与淋巴细胞比值（NLR）和治疗前血小板与淋巴细胞比值（PLR）是影响 pCR 的独立因素。
新辅助化疗联合动脉化疗栓塞有助于提高 LAGC 患者的 pCR 率。动脉化疗栓塞、治疗前 NLR 和 PLR 也是 pCR 的预测因素。
