Neoadjuvant Intraperitoneal and Systemic Chemotherapy Versus Neoadjuvant Systemic Chemotherapy With Docetaxel, Oxaliplatin, and S-1 for Gastric Cancer With Peritoneal Metastasis: A Propensity Score Matched Analysis

Autor: Zhenxin Zhu, Peng Wang, Qingping Cai, Yu Zhang, Huang Xin, Ronglin Yan, Zunqi Hu, Hejing Huang, Dejun Yang, Xin Zhang
Rok vydání: 2021
Předmět:
Oncology
Male
Cancer Research
Peritoneal metastasis
Neoplasm
Residual
Administration
Oral
Docetaxel
propensity score matched analysis
0302 clinical medicine
Treatment for Advanced Gastric Cancer
Antineoplastic Combined Chemotherapy Protocols
Infusions
Parenteral
RC254-282
Peritoneal Neoplasms
Systemic chemotherapy
conversion gastrectomy
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Ascites
Middle Aged
Neoadjuvant Therapy
Oxaliplatin
Survival Rate
Drug Combinations
Treatment Outcome
030220 oncology & carcinogenesis
peritoneal metastasis
030211 gastroenterology & hepatology
Administration
Intravenous
Female
Original Article
neoadjuvant chemotherapy
Adult
medicine.medical_specialty
03 medical and health sciences
Gastrectomy
Stomach Neoplasms
Internal medicine
medicine
Humans
Propensity Score
Aged
Neoplasm Staging
Retrospective Studies
Tegafur
business.industry
Optimal treatment
gastric cancer
Cancer
medicine.disease
Oxonic Acid
Propensity score matching
business
Docetaxel/oxaliplatin
Zdroj: Technology in Cancer Research & Treatment
Technology in Cancer Research & Treatment, Vol 20 (2021)
ISSN: 1533-0338
Popis: Background: The optimal treatment for gastric cancer with peritoneal metastasis (GCPM) remains debatable. This study aimed to compare the efficacy and safety of neoadjuvant intraperitoneal and systemic chemotherapy (NIPS) versus neoadjuvant systemic chemotherapy (NSC) for GCPM. Methods: Patients of GCPM received neoadjuvant chemotherapy with docetaxel, oxaliplatin and S-1 between January 2011 and June 2019 were retrospectively evaluated. Propensity score matched (PSM) analysis was carried out to reduce the selection bias. Multivariate Cox regression model was applied to screen the prognostic factors. Results: After PSM processing, 71 patients in each group were matched among the 186 GCPM patients included. NIPS yielded a better ascites and cytology response to chemotherapy, higher conversion resection rate and R0 resection rate than NSC. The overall survival (OS) rate in NIPS group was better than that in NSC group. Multivariate analysis revealed that the P stage, ascites response, conversion surgery rate and R0 resection rate were independent prognostic factors. Subgroup analysis indicated that NIPS showed a survival benefit over NSC only in patients with cT3-4a, P1-2, whose cytology turned negative, and who received conversion surgery; while not in patients with cT4b, P0 or P3, whose cytology did not turn negative, or who did not receive conversion surgery. Conclusions: NIPS is a safe and feasible treatment for GCPM, which showed more benefit than NSC.
Databáze: OpenAIRE
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