Research progress of neoadjuvant intraperitoneal-systemic chemotherapy for conversion therapy of peritoneal metastasis in gastric cancer

Abstract

In China, peritoneal metastasis of gastric cancer has main characteristics of high incidence, late staging and poor prognosis. However, the proposal of conversion therapy has brought hope to patients. Conversion therapy of peritoneal metastasis in gastric cancer is a novel concept, which aims at down-staging of the gastric cancer′s primary lesion and effectively controlling the peritoneal metastases at the same time through valid chemotherapy and other means. Then the surgeons strive for performing radical gastrectomy and lymph node dissection (D2) to prolong survival time of the patients with advanced gastric cancer and improve their life quality. Systemic chemotherapy is the core of the methods of conversion therapy, while the local intraperitoneal chemotherapy can be used as a supplement. Neoadjuvant intraperitoneal-systemic chemotherapy (NIPS) is the most promising technique as conversion therapy due to the comprehensive advantages of the systemic chemotherapy and local intraperitoneal chemotherapy. In recent years, there were many clinical studies reporting NIPS for conversion therapy of peritoneal metastasis in gastric cancer. Therefore, this paper systematically reviews experiences of clinical application in order to provide references for clinical practice of conversion therapy in gastric cancer. Key words: Gastric neoplasms; Gastric cancer; Peri-toneal metastasis; Conversion therapy; Neoadjuvant intraperitoneal-systemic chemotherapy; Systemic chemotherapy; Hyperthermic intraperitoneal chemotherapy