Clinical efficacy of hyperthermic peritoneal perfusion chemotherapy combined with XELOX chemotherapy in treat-ment of gastric cancer after radical surgery

LU Lin; CUI Xiujie; JIANG Bei

doi:10.3969/j.issn.1671-6450.2015.10.016

Abstract：Objective To observe the clinical efficacy and safety of the gastric cancer radical postoperative intraperi toneal hyperthermic perfusion chemotherapy combined with oxaliplatin (OXA) +capecitabine (Xeloda) (XELOX regimen) adjuvant chemotherapy .Methods From 2011 January to 2012 March, 112 cases gastric cancer patients were enrolled , ac-cording to the method of postoperative treatment , they were divided into observation group (54 cases) and control group (58 cases).Patients in the observation group were given chemotherapy of intraperitoneal hyperthermic perfusion chemotherapy (cisplatin +fluorouracil) 2-3 times, 2 weeks later were given XELOX for 4 cycles of chemotherapy;after surgery, in the control group , patients only received XELOX for 4 cycles of chemotherapy .Compared chemotherapy drug toxicity of the 2 group, after 30 days of chemotherapy , blood samples were collected to detect tumor marker [ carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA19-9)] level.All the patients were followed up to observe the recurrence rate , metas-tasis rate and 3 years survival rate .Results In the observation group after chemotherapy , after 30 days ’ CEA levels was (4.2 ±2.0)μg/L, CA19-9 level was (19.7 ±6.5) U /ml.The control group were (7.1 ±3.1)μg/L, (37.4 ±15.1) U/ml respectively, all were significantly lower than before treatment ( P <0.01), and observation group was significantly lower than that of the control group ( U =5.923, U =8.153, P <0.01).Observation group’s specific toxicity mainly was perito-neal irritation symptoms with 40 cases (18.5%), which was significantly higher than that of control group ’s 2 cases (3.4%) (χ2 =6.639, P =0.010), the rest of the drug toxicity showed no statistical significance differences ( P >0.05).Observa-tion group’s rate of recurrence during the follow-up period was 13.5%, metastasis rate was 19.3%, which were lower than the control group’s 32.1%and 30.4%.The difference of the recurrence rate was statistically significant (χ2 =5.267, P =0.022).The observation group’s 3 years survival rate was 77.8%, which was significantly higher than the control group ’s 58.6%(χ2 =4.705, P =0.030).Conclusion After radical gastrectomy for gastric cancer , combined with XELOX regimen adjuvant chemotherapy and intraperitoneal perfusion chemotherapy can further kill off cancer cells , reduce tumor recurrence and metastasis rate , prolong the long-term survival time , adverse reactions are mild and controllable .