Transarterial Infusion Chemotherapy and Embolization for Patients With Unresectable Advanced Cancer of Stomach or Gastroesophageal Junction: A Retrospective Study

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-11-05 DOI:10.1002/cam4.70396

Lingqiang Min, Zheng Liu, Bo Zhou, Peng Zhou, Rongkui Luo, Yuqin Ding, Yuehong Cui, Zhongyi Shi, Yuan Gu, Yihong Sun, Zhaoqing Tang, Xuefei Wang

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Abstract

Purpose

The feasibility of transarterial infusion chemotherapy and embolization (TAICE) in the treatment of advanced gastric cancer remains unclear. This study explored the value of TAICE in patients with unresectable locally advanced or metastatic cancer of stomach or gastroesophageal junction (GEJ).

Methods

Patients with unresectable gastric cancer who received TAICE for tumor hemorrhage cessation were enrolled in this retrospective study. TAICE was performed using the Seldinger method. The tumor feeding artery was selected for infusion chemotherapy and then was embolized by microspheres or gelatin sponge. Patients involved in this study received one to four cycles TAICE with one to three drugs in the regimen. The possibility of surgery was evaluated after TAICE. Objective response rate (ORR), disease control rate (DCR), R0 resection rate, pathological complete remission (pCR) rate, major pathological remission (MPR) rate, progression-free survival (PFS), overall survival (OS), and safety were analyzed.

Results

Between January 2015 and December 2020, a total of 27 patients received a median of 2 (range, 1–4) cycles of TAICE. ORR and DCR were 33.3% and 74.0%, respectively. Eighteen patients received surgery, and 15 of them underwent gastrectomy and D2 lymph node dissection, with an R0 resection rate of 83.3% (15/18). Four (26.7%, 4/15) patients achieved MPR, but none achieved pCR. The median PFS was 19.8 months (95%CI, 12.1–40.0), and the median OS was 36.1 months (95%CI, 21.0–not reached). Patients with gastrectomy had significantly longer PFS (40.0 vs. 9.5 months, p < 0.0001) and OS (not reached vs. 16.6 months, p < 0.0001) than those without gastrectomy. All the TAICE-related adverse events were manageable, with the most common being fatigue (100%), nausea (63.0%), and vomiting (55.6%). No severe surgical complications occurred.

Conclusion

TAICE was well-tolerated and could be a potential therapy to provide opportunity of surgery for patients with unresectable advanced gastric or GEJ cancer.

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经动脉灌注化疗和栓塞治疗胃或胃食管交界处不可切除的晚期癌症患者：回顾性研究

目的：经动脉灌注化疗和栓塞（TAICE）治疗晚期胃癌的可行性仍不明确。本研究探讨了经动脉灌注化疗和栓塞（TAICE）在不可切除的局部晚期或转移性胃癌或胃食管交界处癌（GEJ）患者中的应用价值：这项回顾性研究纳入了接受TAICE止血治疗的不可切除胃癌患者。TAICE采用Seldinger方法进行。选择肿瘤供血动脉进行输注化疗，然后用微球或明胶海绵进行栓塞。参与本研究的患者接受了一至四个周期的TAICE治疗，治疗方案中包含一至三种药物。TAICE治疗后对手术的可能性进行了评估。对客观反应率（ORR）、疾病控制率（DCR）、R0切除率、病理完全缓解率（pCR）、主要病理缓解率（MPR）、无进展生存期（PFS）、总生存期（OS）和安全性进行了分析：2015年1月至2020年12月期间，共有27名患者接受了中位数为2个周期（1-4个周期）的TAICE治疗。ORR和DCR分别为33.3%和74.0%。18名患者接受了手术治疗，其中15人接受了胃切除术和D2淋巴结清扫术，R0切除率为83.3%（15/18）。4名患者（26.7%，4/15）获得了MPR，但没有人获得pCR。中位PFS为19.8个月（95%CI，12.1-40.0），中位OS为36.1个月（95%CI，21.0-未达到）。胃切除术患者的 PFS 明显更长（40.0 个月 vs. 9.5 个月，P 结论：TAICE 的耐受性良好：TAICE耐受性良好，可作为一种潜在疗法，为无法切除的晚期胃癌或胃食管癌患者提供手术机会。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.