A Clinical Research On The Efficacy And Safety Of Intraperitoneal And Intravenous Paclitaxel Combined With S-1 And Oxaliplatin In The Treatment Of Gastric Cancer With Peritoneal Metastasis

Objective:to evaluate the effects and safety of intraperitoneal and intravenous paclitaxel combined with S-1 and oxaliplatin in the treatment of gastric cancer with peritoneal metastasis.Methods:A case-control study was conducted,the clinical data of 30 patients with gastric cancer with peritoneal metastasis from January 2016 to January 2021 in the Department of Gastrointestinal surgery of the first Hospital of Jilin University were collected.According to the treatment plan,they were divided into group A（n=20）and group B（n=20）.The group A was treated with intraperitoneal and intravenous paclitaxel combined with S-1 and oxaliplatin chemotherapy,The group B was treated with oxaliplatin combined with S-1 chemotherapy.After all patients completed 4cycles of chemotherapy,the differences between the two groups in general conditions,efficacy of chemotherapy,intraoperation conditions,postoperative conditions,histopathological results,chemotherapy-related adverse events,and survival status were compared and analyzed.Results:1.The general conditions of the two groups were similar without significant difference.2.Comparison of efficacy between patients in the two groups: The disease control rate（DCR）of the group A was higher than that in the group B（75% vs 60%,P=0.311）,and the objective response rate（ORR）of the group A was higher than that in the group B（70% vs 30%,P=0.011）.3.In terms of operation and postoperative conditions: the R0 resection rate in the group A was higher than that in the group B（50% vs 20%,P=0.047）.Both groups received adequate lymph node dissection（28.27±2.00 vs 27.17±2.64,P=0.345）,and the overall incidence of postoperative complications was similar（18.1% vs 16.7%,P=1.000）.Postoperative pathology indicted that the pathological response rate in the group A was higher than the group B（81.8% vs 66%,P=0.482）.4.The incidence of anemia,neutropenia,nausea/vomiting and allergic reactions in the group A was higher than that in the group B（P<0.05）,and there was no statistical difference in other adverse reactions（P>0.05）.5.The median OS in the group A was 19 months（95%CI:14.617 vs23.383）,while in the group B was 16 months（95%CI:14.597 vs 17.403）.The median PFS in the group A was 14 months（95%CI:11.078 vs 16.922）while in the group B was 10 months（95%CI:8.961 vs 11.039）.The OS in the group A was superior to the group B[Logrank P=0.012,HR=0.35,95%CI（0.16-0.80）],The PFS in the group A was superior to the group B[Logrank P=0.028,HR=0.40,95%CI（0.18-0.90）].Conclusions:The chemotherapy regimen of intraperitoneal and intravenous paclitaxel combined with oxaliplatin and S-1 can improve the chemotherapy effect and the survival time of patients,increase the surgical R0 resection rate and postoperative pathological remission rate,and the chemotherapy-related side effects can be tolerated.Overall,the chemotherapy regimen is safe and effective.