Regional chemotherapy in locally advanced gastric cancer

Abstract

During 2008-2011 32 patients with locally advanced and metastatic gastric cancer passed 154 procedures of interventional radiology. Tumors of gastroesophageal junction were revealed in 7 patients, tumors of the fundus — in 15 patients, tumors of the pylorus — in 10 patients. At the time of treatment and hospitalization complicated course was observed in 14 patients. Upon initial treatment 25 patients (78%) manifested metastatic lesions in the liver. As an independent type of treatment interventional radiology was carried out in 20 patients. The combined treatment (surgery + intraarterial regional chemotherapy) was performed in 12 patients. 19 patients underwent chemoembolisation of the tumor (56 procedures in total). All patients had repeated courses of intraarterial regional chemoinfusion at intervals of 4-6 weeks (98 procedures in total). Surgical treatment was performed in terms of 7-16 days after the last course of neoadjuvant regional chemotherapy. A decrease of tumor size by 15% -35% (26% in average) was registered in all patients; a decrease in accumulation of radiopharmaceutical in tumors of the stomach was 18% -27% (20% in average). The results of the application of intraarterial regional chemotherapy (chemoembolisation tumors of the stomach and regional chemoinfusion) demonstrated the possibility of effective influence both on the primary tumor, and on the stages of lymph node metastasis. Also the use of regional neoadjuvant chemotherapy did not complicate the course of the postoperative period even in the group of patients who underwent extensive combined surgical intervention.