Zhang Jiajia, Zhou Gang, Yin Meipan, Ma Yishu, He Wei, Bi Yonghua, Wu Gang
Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Road, Zhengzhou, 450052, China.
Department of Oncology Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
J Cancer Res Clin Oncol. 2025 Jun 5;151(6):183. doi: 10.1007/s00432-025-06169-y.
Gastric fundus and cardia cancer are increasingly common, diagnosed at a late stage, often with severe obstruction, and have a poor prognosis. Transcatheter arterial lipiodol chemoembolization (TACE) is rarely used for gastric cancer. This single-center retrospective study aimed to analyze the efficacy and safety of transcatheter arterial infusion chemotherapy (TAI) combined with TACE in advanced gastric fundus and cardia cancer with obstruction and compare it to bland embolization (BE).
The clinical efficacy of TAI-TACE was evaluated through technical and clinical success rates, obstruction relief, tumor response, overall survival (OS), and postoperative adverse events. TAI-TACE and TAI-BE efficacies were compared.
The study included 53 patients (age 70.0 ± 11.1 years, 38 males). Thirty-two patients underwent TAI-TACE, and 21 underwent TAI-BE. The cohort's technical success rate was 100%. The pre- and post-intervention median Stooler grades were 4 and 2 in the TAI-TACE group and 3 and 3 in the TAI-BE group, respectively. Compared to the TAI-BE group, the TAI-TACE group had a higher clinical success rate (78.1%, 25/32 vs. 42.9%, 9/21; P = 0.009), a better objective response rate (53.1% vs. 38.1%; P = 0.016), and a longer median OS (13.0; 95% confidence interval (CI), 3.2-22.8 vs. 10.0; 95% CI, 8.5-11.5; P = 0.039) months. All adverse events were grade 1.
The TAI-TACE interventional therapy scheme was safe and effective, achieving rapid tumor shrinkage, obstructive symptom alleviation, improved quality of life, and a significantly better overall effect than TAI-BE.
胃底贲门癌日益常见，确诊时多为晚期，常伴有严重梗阻，预后较差。经导管动脉碘油化疗栓塞术（TACE）很少用于胃癌。本单中心回顾性研究旨在分析经导管动脉灌注化疗（TAI）联合TACE治疗晚期胃底贲门癌伴梗阻的疗效和安全性，并与单纯栓塞术（BE）进行比较。
通过技术成功率、临床成功率、梗阻缓解情况、肿瘤反应、总生存期（OS）和术后不良事件评估TAI-TACE的临床疗效。比较TAI-TACE和TAI-BE的疗效。
本研究纳入53例患者（年龄70.0±11.1岁，男性38例）。32例行TAI-TACE，21例行TAI-BE。该队列的技术成功率为100%。TAI-TACE组干预前后的中位斯图尔德分级分别为4级和2级，TAI-BE组分别为3级和3级。与TAI-BE组相比，TAI-TACE组的临床成功率更高（78.1%，25/32对42.9%，9/21；P=0.009），客观缓解率更好（53.1%对38.1%；P=0.016），中位OS更长（13.0；95%置信区间（CI），3.2-22.8对10.0；95%CI，8.5-11.5；P=0.039）个月。所有不良事件均为1级。
TAI-TACE介入治疗方案安全有效，可使肿瘤迅速缩小，梗阻症状缓解，生活质量改善，总体效果明显优于TAI-BE。
