Efficacy of Adjuvant Systemic Chemotherapy Combined with Radical Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer Treatment

• Published in: Indian journal of surgical oncology 2020-09, Vol.11 (3), p.337-343
• Main Authors: Reutovich, M. Yu, Krasko, O. V., Sukonko, O. G.
• Format: Article
• Language: English
• Subjects: Cancer surgery; Chemotherapy; Gastric cancer; Medicine; Medicine & Public Health; Oncology; Original; Original Article; Surgery; Surgical Oncology
• ISSN: 0975-7651; 0976-6952
• DOI: 10.1007/s13193-020-01102-w

Evaluation of the efficacy of the combination of radical surgery, hyperthermic intraperitoneal chemotherapy (HIPEC), and adjuvant systemic chemotherapy (ACT) in reducing gastric cancer progression in patients with resectable serosa-invasive gastric cancer in a single institution. In 2015–2016, 19 patients with gastric cancer (stage IIB-IIIC) were included in the trial. The trial protocol comprised radical surgery, HIPEC (cisplatin 50 mg/m 2  + doxorubicin 50 mg/m 2 , 42 °C, 1 hour), and 1–8 cycles of ACT (oxaliplatin 100 mg/m 2 administered on day 1 of each cycle and oral capecitabine 1000 mg/m 2 (or tegafur 10–15 mg/kg) administered twice daily on days 1–14 of each cycle with an interval of 7 days between cycles). Following the ACT treatment, the patients were divided into 2 subgroups—those who underwent up to 6 ACT cycles (1–6 cycles, subgroup ≤ 6–8 patients) and those who underwent 7–8 ACT cycles (subgroup > 6–11 patients). Three-year metastasis-free survival (MFS) for the > 6 subgroup was 91 ± 9%. With a follow-up median of 17 months, 3-year MFS for the ≤ 6 subgroup was not reached −  p log-rank  = 0.003. The trial showed that in managing advanced gastric cancer patients (pT4a-4bN0-3 M0) by supplementing radical surgery with ACT-enhanced hyperthermic intraperitoneal chemotherapy, ACT proved to be highly effective when administered in its full mode of 7–8 cycles compared with its truncated variant of 1–6 cycles.