| 1 ObjectiveCurrently,peritoneal metastasis of gastric cancer can be prevented and treated with intraperitoneal hot irrigation chemotherapy,but choosing medications and treatment plans that can boost the antitumor impact while lowering the toxicity of chemotherapy is a clinical issue.The purpose of this study was to investigate the clinical utility of traditional Chinese medicine combined with anticancer agents in peritoneal hot irrigation chemotherapy,as well as the efficacy of salvia combined with 5-fluorouracil in peritoneal hot irrigation chemotherapy during radical gastric cancer surgery.2 Methods2.1 Case grouping method:The random number table approach in conjunction with the envelope method were used to allocate 61 patients with progressive gastric cancer who satisfied the diagnostic criteria prior to surgery.Of these,30 cases were placed in the observation group and 31 cases were placed in the control group.2.2 Treatment methods(1)Control group:perfect preoperative examination,preoperative and intraoperative prophylactic use of antibiotics,blood preparation,skin preparation,preoperative placement of gastric tube and nutrition tube;use intravenous composite anesthesia with tracheal intubation,perform D2 radical surgery for gastric cancer,before closing the abdominal cavity,repeatedly soak and rinse the abdominal cavity with 3000-5000 ml430C distilled water,and take 50 ml of 5-fluorouracil injection after aspiration(manufacturer:Tianjin Jinyao Pharmaceutical Ltd.10ml/stem,recommended dose of intraperitoneal injection for adults 600mg/m~2)dissolved in 250ml sterilized water for injection and warmed to 43℃,then poured the drug evenly into the abdominal cavity,clamped the drainage tube and opened 1h after surgery.When postoperative feeding was restored,complications were relieved,and physical condition was basically returned to normal,intravenous chemotherapy(SOX regimen)was generally returned to the hospital 4 weeks after surgery:oxaliplatin 130mg/m~2ivgtt d1+tegeo capsules 80mg/m~2po bid d1-d14,A course of treatment was repeated every 21 days for a total of 6 courses.(2)Observation group:intraperitoneal chemotherapy with the addition of Danshen injection 50 ml on the basis of the control group(manufacturer:Shenwei Pharmaceutical Group Co.The rest of treatment was the same as the control group.2.3 Observation indexes and their detection methods(1)Demographic information,such as the patient’s age,gender,tumor type,TNM pathological stage,and degree of tumor differentiation.(2)Changes in liver and kidney function:Total bilirubin(T-Bil),glutamic transaminase(ALT),glutamic oxalacetic transaminase(AST),creatinine(CREA),and urea nitrogen(BUN)were detected by photoelectric colorimetric method through automatic biochemical analyzer in 4 ml of fasting venous blood from patients before surgery,1,3,and 7 days after surgery(H7600-120E type,Hitachi).(3)Myelosuppression:The Coulter principle was used to quantify the white blood cell count(WBC),platelet count(PLT),and hemoglobin concentration(HGB)in 2 ml of fasting venous blood from patients before and 1,3,7,and 14 days after surgery.(4)Tumor markers:The Abbott GLP System-A used a chemiluminescence approach to detect carcinoembryonic antigen(CEA)and carcinoembryonic antigen 199(CA199)in approximately 4 ml of fasting venous blood taken from patients before surgery and at the conclusion of the procedure.(5)Postoperative problems:Anastomotic leak,postoperative intestinal obstruction,hemorrhage,lung infection,inadequate incision healing,and fever were some of the difficulties that were studied using postoperative symptoms,laboratory tests,and imaging results.(6)Survival follow-up:The follow-up endpoint is death,including progression-free survival and overall survival,and the follow-up content includes tumor recurrence and metastasis.Every three months,follow-up was done over the phone and included an outpatient inpatient evaluation.3 Results3.1 Comparison of the general data of the two groups of patientsWhen age,gender,tumor site,TNM pathological stage,and degree of tumor differentiation were compared between the two groups,there was no statistically significant difference(P>0.05).3.2 Comparison of the two groups’differences in changes to liver and renal functionThere was no statistical significance in T-bil,AST,ALT,CREA and BUN between the two groups before surgery and 1 day after surgery(P>0.05);Three days after operation,ALT and AST in the observation group were(39.87±10.49,48.23±10.62),respectively,better than those in the control group(45.61±7.74,54.10±10.33),and the difference was statistically significant(P<0.05);There was no statistical significance in T-bil,AST,ALT,CREA and BUN between the two groups 7 days after surgery(P>0.05).3.3 Comparison of bone marrow suppression between two groups of patientsWBC,PLT,and HGB levels did not differ statistically between the two groups of patients before and one day after surgery(P>0.05).On postoperative day 3,the observation group’s WBC was(8.37±3.12),which was higher than the control group’s(6.66±2.07),and the difference was statistically significant(P<0.05);no statistically significant difference existed between the two groups’WBC,PLT,and HGB on postoperative days 7 and 14(P>0.05).3.4 Comparison of tumor markers between the two groupsThere were significant differences in CEA and CA199 levels between the observation group and the control group before and after the course of treatment(P<0.05).There was no significant difference in the levels of CEA and CA199 between the observation group and the control group before operation(P>0.05).There were significant differences in CEA and CA199 levels between the observation group and the control group after treatment(P<0.05).3.5 Comparison of postoperative complications between the two groupsThe complication rate was 33.3%in the observation group and 38.7%in the control group,and the results showed that there was no statistically significant difference in any of the complication rates between the two groups(P>0.05).3.6 Comparison of survival follow-up between the two groupsThere was a statistical difference in progression-free survival between the two groups as of February 2023 among 61 cases,with 11 cases progressing in the observation group and 18 cases progressing in the control group(Log Rank method test data,X2=5.003,P=0.025).Overall survival rates were 70%and 64.5%,respectively,with no statistically significant difference in overall survival(Log Rank method test statistics,X2=0.562,P=0.454).There were 9 deaths in the study group and 11 deaths in the control group.4 Conclusion1.Danshen combined with 5-fluorouracil intraperitoneal hot irrigation chemotherapy is safe and feasible in radical gastric cancer surgery:Danshen combined with5-fluorouracil does not increase postoperative complications.2.Danshen can increase the anti-tumor effect of 5-fluorouracil:Danshen combined with5-fluorouracil can effectively inhibit tumor recurrence and metastasis and improve patients’progression-free survival time.3.Salvia can reduce the toxicity of 5-fluorouracil:Salvia combined with 5-fluorouracil can reduce the liver function damage and bone marrow suppression caused by5-fluorouracil. |
PDF Full Text Request