| Background and Purpose:The standard postoperative adjuvant chemotherapy regimen for gastric cancer has not been well defined. As a new kind of comprehensive treatment, the efficacy and feasibility of combined intraperitoneal and systemic chemotherapy have been well-established in ovarian cancer. The aim of this study was to evaluate the efficacy and feasibility of adjuvant chemotherapy combined intraperitoneal cisplatin and intravenous (study group), compared with intravenous chemotherapy only (control group) after gastrectomy in patients with resectable gastric cancer.Methods:Between2003.1.1to2009.12.31,60eligible patients with serosa-infiltrating and/or node-positive gastric cancer following curative gastrectomy received combined intraperitoneal cisplatin and intravenous chemotherapy (study group, n=30) or intravenous chemotherapy only (control group, n=30) in Sir Run Run Shaw Hospital. A1:1matched case-control study was conducted with the60patients. The disease-free survival (DFS), overall survival (OS), and the rate of chemotherapy-related adverse events were observed in both groups. Results:Median follow-up was36months in both the study group and control group. The median DFS was23months in the study group and19months in the control group with statistically significance (P=0.041). A decreasing trend of intra-abdominal relapse and metastasis rate in study group compared with control group was observed (P=0.063). The median OS was40months in both study group and control group without statistically significance (P=0.347). The most common adverse events in two groups were myelosuppression and gastrointestinal reactions. The myelosuppression was reported in26cases (86.7%) in both the study group and control group. The gastrointestinal reactions was reported in25cases (83.3%) in the study group and in24cases (80.0%) in the control group.Conclusion:Adjuvant chemotherapy combined with intraperitoneal cisplatin and intravenous after gastrectomy in patients with resectable gastric cancer can prolong the DFS and is well tolerated, compared with intravenous chemotherapy only. However, there is no contribution to improve overall survival, which requires further clinical trial with larger volume and longer follow up. |
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