1. Laparoscopic Hyperthermic Intraperitoneal Perfusion Chemotherapy for Patients with Malignant Ascites Secondary to Unresectable Gastric Cancer.
- Author
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Ba, Ming-chen, Long, Hui, Zhang, Xiang-Liang, Gong, Yuan-Feng, Tang, Yun-Qiang, Wu, Yin-Bing, Yu, Fei-Hong, and Cui, Shu-Zhong
- Subjects
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LAPAROSCOPIC surgery , *ISOLATION perfusion , *HYPERTHERMIC intraperitoneal chemotherapy , *ASCITES , *STOMACH cancer , *MITOMYCIN C , *PATIENTS , *CANCER complications , *CANCER treatment , *ANTINEOPLASTIC agents , *CANCER , *CANCER chemotherapy , *COMBINED modality therapy , *COMPARATIVE studies , *LAPAROSCOPY , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *STOMACH tumors , *THERMOTHERAPY , *PERITONEUM tumors , *EVALUATION research , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *KARNOFSKY Performance Status , *DISEASE complications , *TUMOR treatment , *THERAPEUTICS - Abstract
Background: To compare the efficacy of three chemotherapeutic combinations for laparoscopic hyperthermic intraperitoneal perfusion chemotherapy (HIPPC) in the treatment of malignant ascites secondary to unresectable gastric cancer (GC).Materials and Methods: From January 2010 to December 2013, 38 GC patients were randomly divided into three groups and treated by laparoscopic HIPPC with one of the three following chemotherapy combinations: raltitrexed (Ra) with oxaliplatin [trans-(±)-diaminocyclohexane oxalatoplatinum (l-OHP)], Ra with cisplatin (DDP), and Ra with mitomycin C (MMC). Perioperative complications, patients' quality of life, and survival were recorded and compared among the three groups.Results: The intraoperative course was successful in all patients, and no perioperative death or complication related to laparoscopic HIPPC was documented. The median follow-up period was 9 months, and the median survival was 7.5 months for all patients. Patients in the Ra/l-OHP group had a median survival of 8.7 months, the Ra/DDP group had a median survival of 5.6 months, and the Ra/MMC group had a median survival of 7.5 months. Patients' median survival in the Ra/l-OHP group and Ra/MMC group was significantly longer than in the Ra/DDP group (Pā<ā.05). No significant difference was found in total remission rate of ascites, increase in the Karnofsky Performance Scale, and incidence rate of port-site metastases among the three groups.Conclusions: Laparoscopy-assisted HIPPC provides modest yet encouraging efficacy for malignant ascites secondary to disseminated GC. Our preliminary data indicate that the chemotherapeutic combination of Ra/l-OHP and Ra/MMC might be more beneficial compared with Ra/DDP in terms of patients' survival. [ABSTRACT FROM AUTHOR]- Published
- 2016
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