Abstract
Neoadjuvant and hyperthermic intraperitoneal chemotherapies have been shown to be effective in the treatment of resectable advanced gastric cancer. The aim of the present study was to investigate the clinical efficiency and security of neoadjuvant chemotherapy in combination with hyperthermic intraperitoneal chemotherapy for the treatment of postoperative advanced gastric cancer. A total of 192 patients diagnosed with advanced gastric cancer were randomly divided into the following four groups (n=48 per group): Control, neoadjuvant chemotherapy, hyperthermic intraperitoneal perfusion chemotherapy and joint groups. The joint group received neoadjuvant chemotherapy combined with hyperthermic intraperitoneal perfusion chemotherapy. Complications, adverse reactions, recurrence rates within 2 years and the 1- and 3-year survival rates following surgery were observed. No significant differences were observed in the occurrence rates of I–II degree myelosuppression, III–IV degree myelosuppression, I–II degree nausea or III–IV degree nausea and vomiting among the four groups (P>0.05). The median progression-free survival times were 26, 31, 33 and 28 months in the control, neoadjuvant chemotherapy, hyperthermic intraperitoneal perfusion chemotherapy and joint groups, respectively (P<0.001). Compared with the control group, the recurrence-free 2-year survival rate of the joint group was significantly lower (P=0.04). The difference among the median survival times of the four groups was statistically significant (P=0.001). The 1-year survival rate of the joint group was significantly higher when compared with the control group and the difference was statistically significant (P=0.03). However, no statistically significant difference was identified among the 1-year survival rates of the four groups (P>0.05). Compared with the control group, the 3-year survival rates of the other three groups were significantly higher (P<0.05). Therefore, the results of the present study indicated that neoadjuvant chemotherapy combined with hyperthermic intraperitoneal perfusion chemotherapy for the treatment of advanced gastric cancer is well tolerated and exhibits improved compliance and efficiency.
Highlights
Surgical resection is the only possible curative treatment for gastric cancer, this treatment is limited to stage I early gastric cancer cases
Hyperthermic intraperitoneal perfusion chemotherapy has been shown to effectively eliminate cancer cells that escape to the peritoneal cavity, preventing peritoneal local recurrence and metastasis [4]
There were 1, 2, 1 and 0 cases lost during the follow‐ups in the control, neoadjuvant chemotherapy, hyperthermic intraperitoneal perfusion chemotherapy and joint groups, respectively
Summary
Surgical resection is the only possible curative treatment for gastric cancer, this treatment is limited to stage I early gastric cancer cases. Numerous studies have demonstrated the safety and potency of this treatment, which functions to reduce the pathological stage and improve the surgical resection rate, the R0 resection rate [1]. Neoadjuvant chemotherapy has been shown to reduce postoperative recurrence and metastasis, as well as improve the prognoses of patients with gastric cancer [1,2]. Studies have shown that for advanced gastric cancer with penetrated serosa, neoadjuvant chemotherapy reduces intraperitoneal recurrence and metastasis, increases the overall survival rate of patients [3]. Hyperthermic intraperitoneal perfusion chemotherapy has been shown to effectively eliminate cancer cells that escape to the peritoneal cavity, preventing peritoneal local recurrence and metastasis [4]. Preoperative neoadjuvant chemotherapy was combined with postoperative hyperthermic intraperitoneal perfusion chemotherapy for the treatment of advanced gastric cancer
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