| Objective: To study the expression changes of coelom continued circulatory hyperthermia perfusion and intravenous chemotherapy on Th1/Th2 cytokines in peripheral blood in patients with advanced gastric cancer as well as the Th1/Th2 change data, and to observe the short-term effect, one year survival rate, and toxic and side effect of patients with advanced gastric cancer, in order to provide a theoretical foundation and clinical experience for the treatment of advanced gastric cancer via coelom continued circulatory hyperthermia perfusion.Methods: 60 cases of patients enrolled in the First Affiliated Hospital of Henan University of Science and Technology from October 2012 to October 2014 were randomly divided into two groups, the Coelom Continued Circulatory Hyperthermia Perfusion Group and the Chemotherapy Group. All patients were treated with FOL-FOX chemotherapy. On day 1, patients received Oxaliplatin(L-OHP) l00 mg intravenous infusion and 500 ml of glucose 5% for 2 to 3 hours. Patients were given leucovorin(FA) 200 mg intravenous infusion over 2 hours, right after 250 ml glucose 5%; 5-FU at 400mg/m2 followed in 10 minutes by 22 hours of 5-FU infusion at 600mg/m2 on day 1 and day 2. The treatment was repeated every 3 weeks. The effect and adverse reaction were not observed until the end of two continuous treatment cycles. The Coelom Continued Circulatory Hyperthermia Perfusion Group was given coelom continued circulatory hyperthermia perfusion after taking chemotherapeutics by vein on d1, d3, d5 and d7. After two continuous treatment cycles, the expression changes in specific cytokines in the peripheral blood in patients were analyzed before and after chemotherapy by using a Flow Cytometry. The short-term effect was evaluated by Response Evaluation Criteria in Solid Tumors(RECIST), and the toxic and side effect was graded by Version 3.0 of the National Cancer Institute Common Toxicity Criteria(NCI-CTC).Results: There were statistically significant differences of the expression of Th1/Th2 cytokines in the peripheral blood of 60 cases of patients with advanced gastric cancer(both the Coelom Continued Circulatory Hyperthermia Perfusion Group and the Chemotherapy Group) before and after chemotherapy(P<0.05); Compared to before chemotherapy, the differences of Thl/Th2 values were statistically significant(P<0.05). Before chemotherapy, the Chemotherapy Group did not present any statistically significant differences compared with the Coelom Continued Circulatory Hyperthermia Perfusion Group in the expression levels of Thl/Th2 cytokines from the peripheral blood or the Thl/Th2 values(P>0.05); after chemotherapy, the Chemotherapy Group presented statistically significant differences compared with the Coelom Continued Circulatory Hyperthermia Perfusion Group in the expression levels of Thl/Th2 cytokines from the peripheral blood and the Thl/Th2 values(P< 0.05). All the short-term effects of patients could be evaluated. The treatment efficiencies of the Coelom Continued Circulatory Hyperthermia Perfusion Group(31 cases) and the Chemotherapy Group(29 cases) were 70.9% and41.3%(P<0.05), respectively; the disease control rates(DCR) of the two groups were 93.5% and 79.3%, respectively(P<0.05). For the living condition analysis, the one-year survival rates were 64.52% and 41.3%, respectively(P<0.05), and the two groups shared almost the same hematologic toxicities(grades2-4) and gastrointestinal reactions(P>0.05). The above toxic and side effects were tolerable to the patients.Conclusions: HIPEC combined with FOLFOX treatment can significantly improve the expression of Th1 and Th2 cytokine profiles and Th1/Th2 ratio, and combination therapy exhibits a higher efficacy and survival rate, which might represent a superior therapy for the patients with advanced gastric cancer. |
PDF Full Text Request