Combined intra-arterial and intravenous chemotherapy for unresectable, advanced gastric cancer has an improved curative effect compared with intravenous chemotherapy only

Abstract

The aim of the present study was to evaluate the efficacy and safety of a combination of intra-arterial and intravenous chemotherapy in the treatment of unresectable, advanced gastric cancer, and assess which patients are likely to benefit from combined treatment. The clinical data of 128 patients diagnosed with unresectable, advanced gastric cancer at The Fourth Hospital of Hebei Medical University (Shijiazhuang, China) from January 2009 to September 2012 were retrospectively analyzed. The patients were divided into two groups as follows: Those who received regional intra-arterial chemoembolization plus systemic chemotherapy (combined group; n=62) and those who received systemic chemotherapy only (venous group; n=66). The clinical response, overall survival (OS) and toxic effects in the two groups were compared. Univariate and multivariate analyses were performed to identify the primary factors affecting the survival time of patients in the combined group. The overall response rate was significantly increased (35.5%) in the combined group compared with the venous group (19.7%; P=0.045). The median OS was 14 months in the combined group and 13 months in the venous group, and the 1-year and 2-year survival rates in the two groups were 45.2 and 9.7%, and 40.9 and 6.1%, respectively. There were significant differences between the survival curves (P=0.044). The median time to progression in the combined group and the venous group was 10 months and 6 months, respectively, and the difference was statistically significant (P=0.003). Multivariate analysis revealed that tumor-node-metastasis (TNM)-stage and the degree of tumor staining were independent factors affecting OS. No differences in adverse reactions between the two groups were observed (P>0.05). The combination of intra-arterial and intravenous chemotherapy may effectively improve the rate of clinical response, prolong OS and time to symptomatic progression in patients with unresectable, advanced gastric cancer, in particular those with an earlier TNM stage and distinct tumor staining.

Efficacy of interventional therapy and effect on inflammatory factors in patients with gastric cancer after chemotherapy

“…Atropine (0.5 mg) was injected intramuscularly 30 min before surgery, and 2% lidocaine was used for local infiltration anesthesia. Femoral artery was successfully punctured by Seldinger technique (21). The hook was set and the metal guidewire were placed on the celiac trunk.…”

Gastric transcatheter chemoembolization combined with systemic chemotherapy vs. systemic chemotherapy alone for patients with advanced gastric cardiac cancer presenting with dysphagia: A case control study

“…This technique involves the intra-arterial infusion of chemotherapeutic drugs directly into the tumor-feeding artery, followed by the injection of embolic agents to induce ischemic necrosis of the tumor. GTC allows for high local drug concentrations, effectively reducing tumor vascularity and size, thereby improving dysphagia control in patients with AGCC (4)(5)(6)10,(22)(23)(24). Despite its potential benefits, the use of GTC in combination with SYS for AGCC with dysphagia remains controversial, and comparative studies with SYS alone are lacking.…”

“…This technique involves the intra-arterial infusion of chemotherapeutic drugs directly into the tumor-feeding artery, followed by the injection of embolic agents to induce ischemic necrosis of the tumor. GTC allows for high local drug concentrations, effectively reducing tumor vascularity and size, thereby improving dysphagia control in patients with AGCC ( 4 – 6 , 10 , 22 – 24 ).…”

Calcium channel blockers are associated with lower gastric cancer risk: A territory‐wide study with propensity score analysis

“…Calcium channel blockers (CCBs) are shown to have antineoplastic effects via regulation of cell proliferation and calcium influx in in‐vitro studies 20‐22 . Clinical studies showed that CCBs were associated with improved survival of GC patients 23,24 . However, clinical evidence supporting protective role of CCB in GC development is limited.…”

“…[20][21][22] Clinical studies showed that CCBs were associated with improved survival of GC patients. 23,24 However, clinical evidence supporting protective role of CCB in GC development is limited.…”