关键词: 胃癌, 腹腔热灌注化疗, 奥沙利铂, 腹腔脱落癌细胞

Abstract: Objective We took peritoneal recurrence and metastasis at 1 and 3 years after operation and perioperative complications as the main endpoint，and distant metastasis at 1 and 3 years after operation as the secondary endpoint，to explore the safety and clinical efficacy of oxaliplatin combined with hyperthermic intraperitoneal chemotherapy（HIPEC）in the early application after radical surgery for locally advanced gastric cancer.Methods Retrospective analysis of the clinical data of 100 patients with locally advanced gastric cancer who underwent radical surgery in Affiliated Hospital of Jianghan University，from January 2018 to January 2020. Among them， 55 patients were treated with hyperthermic intraperitoneal chemotherapy at the early stage after radical surgery for gastric cancer，which was defined as the observation group. At the same time，the peritoneal lavage fluid of the patients before and after the thermal perfusion chemotherapy was collected，and exfoliative cytology was performed. 45 cases who only underwent radical resection of gastric cancer were defined as the control group. All patients were treated with 6 - 8 cycles of systemic chemotherapy according to the tegio + oxaliplatin regimen.ResultsThe difference in general clinical data（gender，age，T stage，tumor site，lymph node metastasis）of the two groups of gastric cancer patients was no statistically significant，and the data were comparable. There was no statistically significant difference between the two groups in postoperative serious complications during the perioperative period（P > 0. 05），but there was statistically significant difference in the adverse reactions of bone marrow suppression between the two groups（P < 0. 05）. HIPEC treatment would increase bone marrow suppression. A total of 11 patients in the hyperthermic intraperitoneal chemotherapy group had cancer cells detected by exfoliative cytology before the operation，and the positive rate of exfoliative cells was 20% （11/55）. No cancer cells were detected by exfoliative cytology after hyperthermic intraperitoneal chemotherapy. The difference in distant recurrence and metastasis between the two groups at 1 and 3 years after operation was not statistically significant（P > 0. 05），but the peritoneal recurrence and metastasis in the hyperthermic intraperitoneal chemotherapy group at 1 and 3 years after operation was significantly smaller than that in the control group，and the difference between the two groups was statistically significant（P < 0. 05）.Conclusion Oxaliplatin combined with hyperthermic intraperitoneal chemotherapy can significantly reduce the rate of peritoneal recurrence and metastasis in patients with gastric cancer at 1 and 3 years after operation without increasing postoperative complications in the perioperative period. It can be used as an important adjuvant treatment for patients with gastric cancer and improve the prognosis of patients.

Key words: gastric cancer, hyperthermic intraperitoneal chemotherapy, oxaliplatin, abdominal detachment of cancer cells