Clinical Evaluation On Preoperative Intra-arterial And Oral Chemotherapy For Advanced Gastric Cancer

Objective: To observe the safety and effectiveness of preoperative intra-arterial and oral chemotherapy for advanced gastric cancer.Method: From July 2015 to June 2017,we collected the clinical data of 11 patients who were diagnosed as advanced gastric cancer by endoscopy and biopsy before surgery.Preoperative regional intra-arterial chemotherapy regimen was administered with mixed drugs of Etoposide,Epirubicin,Oxaliplatin(50-100mg/m2 of Etoposide,25-50mg/m2 of Epirubicin,50-100mg/m2 of Oxaliplatin)and selective arterial infusion was based on the site of cancer.Oral administration of Tegafur was taken with the dosage of 60 mg twice a day for 14 days.Preoperative regional intra-arterial chemotherapy was administered after an interval of 28 days for 2 cycles.Gastrectomy was performed 7-14 days after completion of regimen.The clinical symptoms,imaging,pathology,and follow-up were observed.Results: Eleven patients received preoperative intra-arterial chemotherapy,among which the main adverse reactions were gastrointestinal reactions and bone marrow suppression.Their pathological response rates were as complete response(p CR)in 1(9.0%)case,partial response(PR)in 4(36.4%)cases,and stable disease(SD)in 6(54.6%)cases and none(0%)case in progressive disease(PD),and the total response rate(RR)was 5(45.4%)cases.There were 8 patients received surgery after intra-arterial chemotherapy,including 1 patient took surgery in another hospital,while the others didn't.Three patients who did not get surgery after intra-arterial chemotherapy died and their survival time was less than 6 months in 1 case and less than 12 months in 2 cases,respectively.The remaining 8 patients(one patient were treated surgically in another hospital)were successfully followed up.There were 6 survivors and 2 deaths.The survival time of survivors exceeds 12 months,the longest one has so far reached 36 months,and KPS scores are all greater than 90 points.There were 2 patients dead at 6 and 12 month postoperatively.Conclusion: Preoperative regional intra-arterial chemotherapy is safe and effective adjuvant therapy with less toxic reaction and easy control of adverse reactions.At the same time,it can down the tumor stage,increase the surgical resection rate and improve survival time.