Efficacy And Safety Of Hyperthermic Intraperitoneal Chemotherapy Combined With Systemic Chemotherapy Compared With Systemic Chemotherapy Alone For Metastatic Gastric Cancer

Objective Metastatic gastric cancer(MGC)is with increased mortality and poor prognosis despite recent advances in systemic chemotherapy(SC).Current evidence supporting the utility of hyperthermic intraperitoneal chemotherapy(HIPEC)combined with SC for MGC is limited.The purpose of this study is to retrospectively observe the short-term effect,survival benefit and safety of HIPEC+SC in the treatment of MGC,compared with SC alone,and to evaluate the effect and safety of HIPEC+SC for gastric cancer peritoneal metastasis(GCPM)through a systematic literature review and meta-analysis.Both provide evidence-based evidence for treatment of MGC with HIPEC.Methods ?Retrospective analysis was performed on 160 patients with MGC treated with first-line SC.They were 1:1 divided into HIPEC+SC group and SC group.The following information were retrospectively compared:the general information;the primary endpoint:mOS;the secondary endpoints:mPFS,response rate,disease control rate,ly-OS,2y-OS,the incidence of adverse reactions(nausea and vomiting,abdominal pain,abdominal distention,bone marrow suppression,kidney dysfunction,abnormal liver function).?Relevant clinical controlled studies were retrieved from the databases of PubMed,Cochrane Library,EMbase.The study of HIPEC+SC versus SC as first-line treatment was screened.The primary endpoint(mOS)and the secondary endpoints(ly-OS,mPFS,and safety)were analysed.Results ?Retrospective study:compared with SC alone,HIPEC+SC treatment for MGC can prolong mOS(13 months vs.9 months),improve the disease control rate(P<0.05),prolong mPFS(7 months vs.5 months),and improve ly-OS(58%vs.32%,P<0.05).There was not any statistical difference in adverse reactions.?Meta analysis:5 clinical controlled trials were included,enrolling 157 patients(79 in the HIPEC group and 78 in the control group).Compared with SC group,HIPEC+SC group turned out to be of higher improvement in mOS and ly-OS(P<0.01).As for safety,there were no significant differences in adverse events between the two groups.Conclusion ? Retrospective study:compared with SC alone,HIPEC+SC in the treatment of MGC can prolong mPFS,improve disease control rate,improve 1-year survival rate and prolong mOS.It is generally safe and controllable.?Meta analysis:for patients with GCPM,HIPEC+SC compared with SC can prolong mOS,improve 1-year survival rate,benefit the survival of patients and have good security.