Study On The Efficacy And Safety Of Intraperitoneal Hyperthermic Perfusion Chemotherapy Combined With Systemic Chemotherapy In Neoadjuvant Chemotherapy For Locally Advanced Gastric Cancer

Objective "Global Cancer Statistics 2020" shows that gastric cancer is still an important cancer in the world,with nearly one million new cases,ranking fifth in the global annual incidence of cancer and fourth in the global annual mortality rate of cancer.Advanced gastric cancer is prone to peritoneal metastasis,with high mortality and poor prognosis.Among them,peritoneal metastasis is the leading cause of death in patients with advanced gastric cancer.The clinical application of intraperitoneal hyperthermic perfusion chemotherapy can effectively eliminate free cancer cells in the abdominal cavity,prevent peritoneal metastasis and local tumor recurrence,and has been confirmed by related studies.This study aims to explore the efficacy and safety of intraperitoneal hyperthermic infusion chemotherapy combined with systemic chemotherapy in the application of neoadjuvant chemotherapy for locally advanced gastric cancer,and to provide clinical guidance for the optimization of neoadjuvant chemotherapy for advanced gastric cancer.Methods A randomized controlled study of 40 patients with unresectable locally advanced gastric cancer in the Affiliated Hospital of Qinghai University from October1,2019 to January 1,2021 was collected as the research objects,and they were divided into two groups of chemotherapy,one group received only neoadjuvant Chemotherapy DSOX(docetaxel + oxaliplatin + ticgio),a group of intraperitoneal hyperthermic infusion chemotherapy combined with systemic chemotherapy: SOX(oxaliplatin +ticgio)+ docetaxel intraperitoneal hyperthermic infusion chemotherapy;To observe and compare the short-term efficacy of the two groups(according to the solid tumor evaluation standard RECIST1.1 to evaluate the tumor remission after 2 cycles of neoadjuvant chemotherapy;according to the tumor regression grading TRG(grade 0-3)to evaluate the tumor regression after neoadjuvant chemotherapy)and safety Sex(the assessment of toxic and side effects is based on the NCI-CTC 3.0 standard,divided into 0-4 levels).In terms of baseline data,the gender(P=1.000),age(t=-0.270,P=0.788),BMI(t=0.359,P=0.721),tumors of the(HIPEC+SOX)group and the(DSOX)group were compared.Borrmann classification(Z=-0.315,P=0.752),tumor pathological differentiation(Z=-0.631,P=0.528),postoperative Lauren classification(P=1.000),tumor location(x^2=1.392,P =0.858),the differences were not statistically significant and comparable.Results(1)In terms of short-term curative effect,according to the solid tumor curative effect evaluation standard RECIST1.1,the HIPEC+SOX group is better than the DSOX group in terms of tumor changes(Z=-2.066,P=0.039),and the HIPEC+SOX group has a higher effective rate than DSOX In the two groups(x^2=-,P=0.022),the two groups of tumor shrinkage in the HIPEC+SOX group were more shrinking than in the DSOX group(Z=-2.265,P=0.024).(2)According to NCI-CTCAE3.0 version,the adverse reactions of HIPEC+SOX group and DSOX group after chemotherapy were evaluated.The two groups were in bone marrow suppression,abnormal liver function,abnormal renal function,nausea,vomiting,abdominal pain,diarrhea,oral cavity There was no significant difference in adverse reactions such as mucositis and peripheral nerve injury(P>0.05).Conclusion(1)Compared with DSOX group,HIPEC+SOX group has better short-term curative effect than DSOX group.After 2 cycles of neoadjuvant chemotherapy,enhanced CT evaluation is performed.HIPEC+SOX group has a higher remission rate.Postoperative tumor evaluation The withdrawal is more obvious.(2).The toxicity of the HIPEC+SOX group and the DSOX group were similar.No serious adverse reactions were found during the treatment,and the toxicity of the two groups was within controllable range.