The Effect Study Of Thermostatic Hyperthermic Intraperitoneal Chemotherapy Combined With Intravenous Chemotherapy After The Advanced Gastric Carcinoma Operation In The Elderly

Background/Purpose:Gastric cancer is one of the most common malignant tumor of digestive tract. An estimated 87.6 thousand new cases of gastric occur annually and the global death toll is up to 64.7 thousand cases according to statistical data.The morbidity of gastric cancer in our country demonstrated upgrade tendency in recent years.It is the third leading cause of cancer death and estimated 400 thousand new gastric cancer cases occurred in our country.Due to the poor prognosis effect of gastric cancer,it had 24 months average survival rates after operation for the early surgical resection.The relevant data shows estimated 20% patients may appear peritoneal metastasis after gastric cancer surgery included 40%-60% peritoneum damage at the early clinical manifestations.The survival rate of peritoneal metastasis patients in gastric cancer is extremely low which may survive 6-8 months after conservative treatment.This is why the therapist seek a best way to improve the prognosis after gastric cancer operation.It has improved the prognosis after gastric cancer operation to some extent as the renewal and the improvement of surgical technique% surgical instruments, and related inspection equipment in our country and the consummate and extension use of chemoradiotherapy and combining therapy(such as immunotherapy、biologicals and traditional Chinese medicine therapy and so on)Most of the surgeon thought it was feasible to perform extended lymph node dessiction at the advanced gastric cancer operation which could be written into the NCCN cancer guidelines as the standard operation method in gastric cancer.It could improved the prognosis with the adjuvant therapy after surgery.Radiotherapy and interventional radiology treatment could be used after the advanced gastric cancer operation and Locally advanced unresectable gastric cancer.Recently,the therapist are trying to use a variety of new adjuvant treatment method to treat the cancer although the poor prognosis effect after advanced gastric cancer operation which include the chemotherapy.The cancer cell may appear a period of rapid appreciation which we called GO period between 24 hours after palliative resection and appear macroscopic recurrent foci between one week according to the clinical research by Fisher.In other words,it is the best period to take the chemotherapy in the first week after operation.Intraperitoneal chemotherapy is the earliest way of chemotherapy in gastric cancer.Hyperthermic intraperitoneal chemotherapy is one of the earliest chemotherapy way to treat the malignant ascites in the gastric cancer and improve the survival quality which use the coordinating role of drug heat effect combined with chemotherapy to improve the effect of drug.Patients could survived for 35 months after hyperthermic intraperitoneal chemotherapy if appeared peritoneal metastasis in gastric cancer according to the literature reports which showed the value of hyperthermic intraperitoneal chemotherapy to improve prognosis.The feasibility、 security and the curative effect of hyperthermic intraperitoneal chemotherapy had been proved after clinical practice by the researchers and literature.It has been the one of the latest way to treat gastric cancer.In order to study the curative effect and security of hyperthermic intraperitoneal chemotherapy combined with intravenous chemotherapy after the advanced gastric carcinoma operation, we choose the elderly in advanced gastric.This study aim to observe the curative effect、the recurrence and metastasis and toxic and side effect of hyperthermic intraperitoneal chemotherapy combined with intravenous chemotherapy after the advanced gastric cancer operation in the elderly to seek a reasonable clinical treatment.Methods:This study selected randomly the elderly after the advanced gastric cancer operation as the research object between 2011 to 2013 at the first affiliated hospital of guangzhou university of TCM to observe the curative effect、the recurrence and metastasis and toxic and side effect of hyperthermic intraperitoneal chemotherapy combined with intravenous chemotherapy.Results:The vital signs、toxic and side effect of the treatment group which took the hyperthermic intraperitoneal chemotherapy after surgery had no statistical differences compared to the control group(P>0.05).The improvement of life quality in the treatment group had significantly statistical differences compared to the control group(P<0.05).Both the local recurrence and the distant metastasis rate in the treatment group were significantly lower than the control group(P<0.05).The CEA、 CA199、AFP in the treatment group was significantly lower than the control group which had significant statistically differences(P<0.01).Conclusions:The hyperthermic intraperitoneal chemotherapy combined with intravenous chemotherapy after the advanced gastric cancer operation in the elderly had no any effect to the vital signs of patient which was with the high security and low toxic and side effect.It could improve the life quality significantly and reduce the local recurrence of gastric cancer and the distant metastasis rate.