Evaluation Of Clinical Efficacy Of Regional Transarterial Infusion Chemotherapy Combined With Lipiodol Chemoembolization In The Treatment Of Advanced Carcinoma Of Gastric Fundus And Cardia

Background and objective:With the improvement of people's living standards,the incidence of gastric cancer has decreased in recent years,but it is still the fifth largest cancer in the world,and it ranks third among the related death factors caused by tumor.Early gastric cancer is difficult to detect because of the hidden clinical symptoms,patients are often at the end stage of the tumor and lose the opportunity of surgery when they go to see a doctor.The effect of conventional radiotherapy and chemotherapy for end-stage patients is usually not ideal,and the side effects are often intolerable.Therefore,we want to design a more effective treatment strategy for patients with gastric fundus and cardia cancer tumor.This study aims at the safety and efficacy of regional transarterial infusion(TAI)chemotherapy combined with lipiodol chemoembolization in the treatment of advanced gastric fundus and cardia carcinoma.Materials and methods:We treated 30 patients with advanced gastric fundus and cardia carcinoma from February 2012 to October 2018.Consecutive patients of advanced gastric fundus and cardia carcinoma were given regional TAI chemotherapy ended in lipiodol chemoembolization once a month with a one-month postoperative observation at each time in 1 to 4 times conditionally.Result:TAI chemotherapy integrated with lipiodol chemoembolization was successfully accomplished in 30 cases of primary gastric fundus and cardia carcinoma without severe complications.2 cases(6.7%)reached CR postoperative and PR,SP,PD reached in 22(73.3%),3(10.0%),3(10.0%),respectively.Total disease control rate(DCR)and the total objective effective rate(ORR)was 90.0% and 80.0%.28 patients complained dysphagia at a variable degrees preoperative all attained conditional relief after operation.Among whom,5 patients with dysphagia grade 4 gained oral nutrition and 6 patients with active gastrointestinal haemorrhage were cured.All cases were under surveillance and 27 patients were followed up successfully.By the end of the final follow-up,10 patients had survived for 2.2-80.0(21.5 ± 24.2)months.17 patients died of tumor progression and tumour-related functional failure.Survival time in 15 cases(55.6%),11 cases(40.7%),and 5 cases(18.5%)was more than 6 months,12 months,and 24 months,respectively.The median survival time was 12 months.Conclusion:Regional TAI chemotherapy combined with lipiodol chemoembolization is safe and effective in the treatment of advanced gastric fundus and cardia carcinoma,in which patients will benefit from a long survival time and quality life.