Efficacy of postoperative intraperitoneal hyperthermic perfusion chemotherapy with oxaliplatin + 5-Fluorouracil in the treatment of gastric cancer patients with peritoneal carcinomatosis.

ABSTRACT

PURPOSE: To explore the effect of palliative laparoscopic resection of gastric cancer combined with intraperitoneal hyperthermic perfusion chemotherapy (IHPC) with oxaliplatin + 5-fluorouracil (5-FU) on gastric cancer patients with peritoneal carcinomatosis (PC). METHODS: 90 patients definitely diagnosed with gastric adenocarcinoma and PC and admitted to our hospital from March 2013 to March 2016 were collected and divided into IHPC group (n=45) and control group (n=45). In IHPC group, IHPC with oxaliplatin + 5-FU was carried out for the first time on the first day after operation, and then it was conducted once every other day for a total of 4 times. The clinical efficacy, quality of life, adverse reactions, postoperative tumor recurrence and survival of the patients were observed and recorded. RESULTS: The total effective rates in IHPC group and control group were 62.2% (28/45) and 55.6% (25/45), respectively (p>0.05). In both groups, the curative effect was the best in moderately differentiated adenocarcinoma and worst in signet ring cell carcinoma. Besides, the effective rates of Karnofsky performance status (KPS) in the two groups after operation were 82.2% (37/45) and 75.6% (34/45), respectively (p=0.606). However, the renal function indexes, serum creatinine (sCr) and blood urea nitrogen (BUN) in the two groups of patients after operation were increased, and those in the IHPC group were higher than those in the control group (p=0.016, p=0.010). Moreover, follow-up results of patients' survival revealed that the OS and PFS in the IHPC group were significantly higher than those in the control group (p=0.041, p=0.045). CONCLUSIONS: Palliative laparoscopic resection of gastric cancer combined with IHPC with oxaliplatin +5-FU has a definite therapeutic effect on gastric cancer with PC, which can achieve a better short-term clinical therapeutic effect and better postoperative quality of life.