Efficacy Of Preoperative Systemic Vein Chemotherapy Combined With Regional Intra-arterial Chemoembolization On Patients With Locally Advanced Gastric Cancer

AimTo investigate the efficacy and safety of preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization in the treatment of locally advanced gastric cancer.MethodsThe clinical data for158patients with locally advanced gastric cancer who had been treated at the First Affiliated Hospital of Zhengzhou University from January2008to July2012were retrospectively analyzed, who all received radical gastrectomy operation. The patients were divided into two groups, these who received preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization (group A, n=78) and those who received preoperative systemic vein chemotherapy (group B, n=80). All cases involved in this study were treated with preoperative therapy who needed to be examined with16-slice spiral CT after two periods preoperative therapy. We evaluated the primary tumor according to the RECIST (Version20091.1) standard for the treatment of neoadjuvant lesion size imaging changes of the evaluation of curative effect. If it can be removed, followed by radical resection3to4weeks later. The overall effective rate of histopathological evaluation,the incidence of toxicity reaction and postoperative complications were compared between two groups.ResultsAll patients had surgical specimens eligible for histopathological assessment. The overall satisfactory rate was significantly higher at60.26%in group A compared with42.5%in group B (χ2=6.136, P<0.05).The incidence rate of toxicity reaction (except nausea) were all lower in group A than in group B (all P<0.05). The difference of such characteristics as acute toxicity between them was significant (P<0.05), and perioperative no mortality related to neoadjuvant therapy; most of the patients’ toxicity reaction in group A were elementary reaction (Grade1,2), who can tolerate by using granulocyte colony stimulating factor, antanacathartic, nutraceutical drug; while more severe reactions (Grade3,4) occured in group A, who needed to be treated with granulocyte colony stimulating factor, antanacathartic, nutraceutical drug, and extended treatment interval time, reduced the dosage of chemoradiotherapy, while the incidence rate of nausea was higher in group A than in Group B (χ2=16.458, P<0.001), who all can tolerate by treated with antanacathartic.The incidence rate of postoperative complications such as anastomotic leakage, intestinal obstruction, poor wound healing, abdominal infection and pulmonary infection were all lower in group A than in group B (all P<0.05).There was no perioperative mortality related to neoadjuvant therapy in two groups.Conclusions1. Preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization was associated with better efficacy in histopathological evaluation than systemic vein chemotherapy in the treatment of locally advanced gastric cancer.2. Preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization was fewer toxicity reactions than systemic vein chemotherapy in the treatment of locally advanced gastric cancer, all patients had well-tolerated regimens.3. Preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization wasn’t more incidence rate of postoperative complications than than systemic vein chemotherapy in the treatment of locally advanced gastric cancer, such as anastomotic leakage, intestinal obstruction, poor wound healing, abdominal infection and pulmonary infection.