Efficacy,Safety And Drug Comparison Of Hyperthermic Intraperitoneal Chemotherapy In Patients With Locally Advanced Gastric Cancer

Objective: Hyperthermic intraperitoneal chemotherapy has an important part in treating and preventing the peritoneal metastasis of patients those with advanced gastric cancer.It can remove the possible free cancer cells in the body cavity and improve patient prognosis in the form of chemotherapy and heat treatment.For patients with locally advanced gastric cancer,the availability and safety of hyperthermic intraperitoneal chemotherapy are not yet clear.This study explores the effectiveness and clinical safety of preventive hyperthermic intraperitoneal chemotherapy for patients with locally advanced gastric cancer and compare the difference in the application of Lobaplatin and Raltitrexed in the preventive hyperthermic intraperitoneal chemotherapy for patients.Methods: The patients with locally advanced gastric cancer who took the surgery in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were retrospectively analyzed.The patients were then divided into groups according to whether to perform hyperthermic intraperitoneal chemotherapy,and the baseline difference between the two groups was eliminated by applying the propensity score matching method.The survival difference between the patients after hyperthermic intraperitoneal chemotherapy was analyzed by follow-up and Log-rank test,and the safety and coagulation function changes of the patients after hyperthermic intraperitoneal chemotherapy were explored by chi-square test and rank sum test.To explore the risk factors affecting the incidence of deep venous thrombosis after radical surgery combined with hyperthermic intraperitoneal chemotherapy by using logistic regression analysis.The patients were separated into groups due to the drugs used in hyperthermic intraperitoneal chemotherapy,and the Log-rank test were used to explore the safety and effectiveness of the preventive treatment of Lobaplatin and Raltitrexed in patients with locally advanced gastric cancer.Results:1.After matching,compared with simple radical surgery,the 1-year and 2-year relapsefree survival rates were 62.9% and 37.8%.In patients treated with radical surgery and hyperthermic intraperitoneal chemotherapy,the 1-year and 2-year relapse-free survival rates were 76.7% and 66.1%.Preventive hyperthermic intraperitoneal chemotherapy improved the relapse-free prognosis of gastric cancer patients(X~2= 4.468,P=0.035).It was more significant in patients with positive nerve invasion,vascular invasion or tumor diameter ≤ 5cm.2.In the safety analysis,hyperthermic intraperitoneal chemotherapy reduced the incidence of postoperative wound complications in patients with locally advanced gastric cancer,but increases the risk of postoperative bone marrow suppression.The overall incidence of postoperative adverse events had not increased,and the postoperative coagulation function of patients had not changed significantly in the patients with locally advanced gastric cancer.The safety of preventive hyperthermic intraperitoneal chemotherapy was acceptable.3.In the study of drug comparison,Lobaplatin had a more obvious effect on improving the prognosis of patients than Raltitrexed(X~2= 4.317,P=0.038),but there is no significant difference in the safety of the two drugs used in the patients with locally advanced gastric cancer.Conclusion: Preventive hyperthermic intraperitoneal chemotherapy can make improvements in the recurrence free survival of those patients who are with gastric cancer after surgery,and its clinical safety is acceptable.In addition to the possible risk of bone marrow suppression,it will not increase the incidence of other postoperative adverse events,but reduce the incidence of wound complications,and has no significant impact on the blood coagulation function of patients after surgery.There was no significant difference in the safety of the use of Lobaplatin and Raltitrexed in the preventive hyperthermic intraperitoneal chemotherapy for gastric cancer,but the efficacy of Lobaplatin was significantly better than that of Raltitrexed.